F5 


M 


UC-NRLF 


$B    L57    ^7D 


G 


An  Experimental  Study  of 
Stuttering 


BY 

JOHN  MADISON  FLETCHER 


A  DISSERTATION  SUBMITTED  TO  THE  FACULTY  OF 
CLARK  UNIVERSITY,  WORCESTER.  MASS.  IN  PARTIAL 
FULFILMENT  OF  THE  REQUIREMENTS  FOR  THE 
DEGREE  OF  DOCTOR  OF  PHILOSOPHY,  AND  ACCEPTED 
ON  THE  RECOMMENDATION  OF  JOHN  WALLACE  BAIRD 


Reprinted  from  the  American  Journal  of  Psychology 
April,  1914,  Vol.  XXV,  pp.  201-255 


I  N^      I     —    < 


F5^ 


^^* 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING* 


By  John  Madison  Fletcher 


I.    Introduction  301 

II.    Differentiation  and  Definition 203 

III.  Physiological 206 

A.  Breathing 

a.  Historical;  b.  Subjects;  c.  Method;  d.  Results 

B.  Vocalization 

a.  Method;  b.  Results 

C.  Articulation 

a.  Method;  b.  Results 

D.  Accessory  Movements 

a.  Tics;  b.  Larynx  Movements;  c.  Miscellaneous  Move- 
ments 

IV.  Psycho-physical   224 

a.  Method;  b.  Results 

a.  Volumetric  Changes 
/3.  Changes  in  Heart-Rate 
;'.  Galvanic  Changes 

V.    Interpretation  229 

VI.    Psychological  230 

A.  Emotions 

a.  Historical;  b.  Results 
a.  Objective 
fi.  Subjective 

B.  Attitudes 

C.  Imagery 

D.  Attention 

E.  Responsibility  for  Aufgabe 

F.  Psychoanalysis 

G.  Association 

VII.    Heredity    247 

VIII.    Conclusions   247 

IX.     Bibliography    249 

X.    Illustrative  Plates 255a 


I.    Introduction 

The  aim  of  the  present  thesis  is  to  offer  a  psychological 
study  of  stuttering.  This  phenomenon  is  a  familiar  one  but 
it  has  received  scant  notice.  The  only  scientific  attention  that 
has  been  paid  to  it  has  come  from  medical  authorities.  To 
the  medical  fraternity  it  has  been  known  at  least  since  the 

*  From  the  Psychological  Laboratory  of  Qark  University. 


202     •'••  '  fllix:her 

days  of  the  Egyptian  hieroglyphics  (19) ;  but  from  the  medi- 
cal point  of  view  there  is  yet  no  concensus  of  opinion  as  to 
its  nature  or  its  treatment. 

In  reference  to  the  question  of  incidence  no  complete  sta- 
tistics are  available.  On  the  basis,  however,  of  certain  care- 
ful estimates  it^  is  claimed  (24;  38-39)  that  there  are  ap- 
proximately a  half  million  speech  defectives  in  the  United 
States.  This  number  is  much  in  excess  of  the  number  of  the 
blind,  the  deaf  and  dumb,  the  insane,  or  the  feeble-minded. 

Defects  of  speech  are  considered  to  be  of  more  scientific 
and  practical  importance  in  Germany  than  in  the  United 
States.  In  1886,  under  Minister  of  Education  von  Gossler, 
the  government  began  activities  on  behalf  of  these  defectives 
which  have  not  ceased  (72;  112  ff.).  Owing  to  the  efforts  of 
the  late  Dr.  A.  Gutzmann  and  his  son.  Dr.  H.  Gutzmann, 
the  University  of  Berlin  has  been  the  source  from  which 
teachers  from  the  various  cities  of  Europe  have  secured  train- 
ing for  service  in  the  schools.  Japan,  through  the  activities 
of  Isawa,  has  also  taken  an  interest  in  the  problem.  In  the 
United  States  the  subject  has  not  received  its  due  scientific 
attention,  while  the  practical  handling  of  the  problem  has 
been  almost  totally  neglected.  The  victims  are  not  even  pro- 
tected from  the  charlatans  who  prey  upon  them. 

It  is  hoped  that  the  present  research  will  show  materials 
for  laboratory  use  in  the  study  of  other  problems  of  general 
psychology.  Advantage  could,  of  course,  not  be  taken  of 
all  the  ramifications  of  the  problem;  nevertheless  the  clinical 
cases  used  in  our  investigation  seemed  constantly  to  afford 
excellent  materials  for  the  study  of  such  topics  of  general 
psychological  interest  as  the  physiological  expression  of  emo- 
tions, the  phenomena  of  inhibition  and  association,  the  Auf- 
gabe  consciousness,  communication,  motor  co-ordination,  vol- 
untary control,  attention,  etc.  Our  cases  presented  a  variety 
of  mental  conditions  that  are  capable  of  being  repeated  at 
will,  conditions  which  it  would  be  impossible  to  produce  with 
normal  subjects  under  the  usual  laboratory  conditions.  Yet, 
unlike  the  insane  or  the  feeble-minded,  they  possess  an  intel- 
ligence that  is  normal ;  and  hence  they  are  able  to  carry  out 
detailed  instructions  and,  if  trained,  to  introspect. 

This  study,  however,  is  not  an  attempt  to  fill  a  lacuna  in 
any  psychological  system;  it  is  a  frank  appropriation  of  the 
ordinary  methods  of  laboratory  psychology  for  the  study  of 
a  problem  that  seems  to  be  not  only  a  legitimate  one  for 
psychology,  but  also  a  problem  that  is  of  sufficient  value  to 
justify  the  research.    It  is  to  be  hoped  that  the  practical  valrie 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  203 

that  the  problem  happens  to  possess  will  not  rob  it  of  its 
scientific  interest  for  those  who  hold  to  the  Wundtian  notion 
of  the  province  of  pure  psychology.^ 

The  study  seems  to  have  turned  out  to  be  neither  exclu- 
sively functional  nor  exclusively  structural.  It  was  found 
necessary  to  view  the  phenomenon  of  stuttering  from  both 
aspects,  a  fact  which  cannot,  of  course,  be  said  to  make  of 
it  a  peculiar  problem.  It  also  seems  to  lie  somewhat  between 
the  fields  of  normal  and  abnormal  psychology.  The  subjects 
are  not  to  be  distinguished  physically  from  other  people ; 
they  are  of  normal  intelligence ;  their  thought  processes  are 
logical.  In  the  linking  of  ideas  with  the  motor  processes  of 
speech,  however,  they  are  not  normal.  Arising  out  of  this 
inability  there  are  to  be  found  certain  other  associated  ab- 
normal conditions  that  are  to  be  indicated  in  detail  later. 

It  is  desired  that  the  present  study  will  help  toward  the 
narrowing  of  the  problem  to  more  convenient  proportions. 
At  the  present  stage  it  is  necessarily  comprehensive.  In  order 
to  reduce  it  to  as  narrow  a  compass  as  possible  the  following 
main  problems  have  been  set:  /.  to  describe  stuttering  in 
terms  of  its  physiological  manifestations ;  2.  to  enumerate  and 
describe  the  associated  mental  conditions ;  and  J.  to  ascertain, 
if  possible,  the  part  played  by  these  mental  states  in  its 
causation. 

II.     Differentiation  and  Definition 

In  order  to  avoid  confusing  stuttering  with  other  forms  of 
speech-defects  it  will  be  necessary  to  adopt  a  differentiation 
of  the  several  groups  of  defects,  which  for  present  use  will 
be  as  follows : 

7.  There  is  a  class  of  speech-defects  resulting  from  dis- 
eases or  lesions  in  those  portions  of  the  brain  that  have  to 
do  with  the  function  of  speech.  This  type  of  defect  is  known 
as  aphasia.  It  may  be  sensory,  motor,  or  associative,  accord- 
ing as  the  region  of  the  brain  affected  is  a  receptive,  emissive, 
or  associative  center.  There  are  many  types  of  this  defect, 
such  as  aphemia,  agraphia,  alexia,  apraxia,  etc.  It  is  an 
organic  disorder  due  to  the  degeneration  or  destruction  of 
brain  tissue ;  it  is  therefore  a  form  of  dementia  and  hence  is 
a  problem  for  psychiatry  rather  than  for  psychology.  It  will 
not  be  taken  into  account  in  the  present  study. 

2.     Secondly,    we   have   a   class    of   speech    defects    to   be 

^  W.  Wundt,  Ueber  reine  und  angewandte  Psychologic,  Psychol. 
Stud.,  V.  igog,  1-47. 


N^ 


204  FLETCHER 

designated  in  this  connection  as  "  stammering."  Schulthess 
(24;  27)  in  1830  recognized  this  as  a  distinct  type  of  defect, 
and  differentiated  it  from  stuttering  by  the  adoption  of  the 
two  terms  "  Stottern "  and  "  Stammeln,"  which  are  still  in 
use  in  Germany.  In  England  and  America  the  terms  "  stut- 
tering "  and  "  stammering  "  are  used  synonymously,  with  the 
result  that  a  confusion  exists  as  to  the  two  conditions  desig- 
nated by  these  terms.  To  avoid  this  confusion  it  has  been 
suggested  that  technical  terms  be  adopted  to  designate  the 
two  fundamentally  different  defects.  Scripture  (127)  pro- 
poses the  terms  "  hypophonia  "  and  "  hyperphonia  "  to  desig- 
nate stammering  and  stuttering  respectively.  "  Hypophonia," 
he  says,  is  "  subenergetic  phonation,"  while  "  hyperphonia  "  is 
"  superenergetic  phonation."  This  terminology  is  open  to  the 
objection  that  a  differentiation  on  the  basis  of  the  amount 
of  nervous  energy  employed  in  speaking  does  not  harmonize 
with  the  facts.  Stuttering  is  not  merely  speaking  with  an 
excess  of  nervous  energy ;  nor  does  stammering  consist  merely 
in  speaking  with  a  less  amount  than  normal. 

Dr.  Makuen  has  proposed  terms  that  more  nearly  describe 
actual  conditions  (98).  For  stuttering  he  proposes  the  term 
"  dyslalia,"  or  difficult  speech ;  for  stammering  he  proposes 
the  term  "  pseudolalia,"  or  incorrect  speech.  However,  be- 
tween the  difficulty  of  securing  the  general  adoption  of  a  new 
terminology  and  that  of  differentiating  the  terms  already  in 
use,  the  writer  has  chosen  the  latter  alternative  mainly  be- 
cause this  does  not  necessitate  a  break  with  the  terms  in  use 
in  the  German  literature  of  the  subject,  which  is  the  most 
extensive. 

Stammering  is  mispronunciation  (107;  567-568).  The 
stammerer,  unlike  the  stutterer,  can  always  speak;  but  his 
speech  is  incorrect.  This  type  of  defect  is  found  in  two 
forms,  namely,  (i)  the  anatomical,  and  (2)  the  developmen- 
tal. The  anatomical  stammer  is  due  to  a  malformation  of  one 
or  more  organs  of  articulation,  as  the  lips,  tongue,  teeth,  hard 
or  soft  palate,  the  nasal  or  pharyngeal  cavities,  etc.  The  de- 
velopmental stammer  has  no  such  physical  cause,  but  is  due 
to  the  incorrect  functioning  of  the  organs  of  articulation  re- 
sulting in  certain  cases  from  immaturity,  as  in  the  "  baby 
talk  "  of  normal  children,  in  whom  the  condition  is  not  re- 
garded as  pathological  unless  it  is  prolonged  beyond  the  age 
of  five  or  six  years   (24;22).'^    The  developmental  stammer, 

J  2  Colman  (22 ;  454)  gives  an  extreme  case  of  "  baby  talk,"  or  infantile 
stammer.  This  child  in  attempting  to  say  the  Lord's  Prayer  spoke  as 
follows :  "  Oue  Tade  na  ah  in  edde,  anno  de  Di  na,  I  tidde  tah,  I  du 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  205 

which  is  characteristic  of  all  children  at  an  early  age,  arises 
from  incomplete  perception  of  vocal  sounds  and  from  lack  of 
co-ordination  of  the  muscles  of  articulation.  Lisping  is  a  / 
common  form  of  stammer  and  consists  in  the  substitution  of 
th  sounds  for  those  of  ^  and  2.  The  organic  type  of  this 
defect  is  due  to  the  shortness  of  the  lingual  frenum,  or 
"  tongue-tie."  *  Stammering  possesses  no  special  psychologi- 
cal interest  and  will  not  be  considered  in  the  present  study. 

5.  Thirdly,  there  is  a  class  of  defects  to  be  designated  as 
"  stuttering."  This  group  is  distinguished  from  the  foregoing 
types  mainly  by  its  intermittent  character.  Stuttering  may  be 
called  a  temporarily  appearing  inability  to  begin  the  pronun- 
ciation of  a  word  or  syllable.  (107;  567-568).  The  capacity 
of  the  stutterer  to  speak  seems  to  be  related  to  certain  mental 
attitudes  or  states  of  mind.  It  is  this  characteristic  that  gives 
the  subject  its  psychological  interest. 

The  evidence  for  the  diagnosis  of  this  defect  as  primarily 
mental  seems  to  be  accumulating.  It  was  formerly  thought 
to  be  due  to  permanent  anatomical  anomalies,  which  were 
amenable  to  surgical  treatment  (28).  Wedge-shaped  portions 
were  cut  from  the  back  of  the  tongue ;  the  hypoglossal  nerve, 
the  lingual  frenum,  and  the  various  extrinsic  and  intrinsic 
muscles  of  the  tongue  were  severed.  The  tongue  was  pierced 
with  needles.  Cauteries,  blisters,  and  embrocations  of  petro- 
leum, also  inoculations  of  croton  oil  were  administered.  Tinc- 
ture of  rectified  alcohol,  peppermint  oil  and  chloroform  were 
applied.  Wooden  wedges  were  placed  between  the  teeth.j 
Smoking  was  recommended  as  a  sedative  to  the  vocal  cords. 
The  above  and  various  other  remedies  were  devised  on 
the  assumption  that  the  difficulty  was  organic  and  peri- 
pheral (103).  This  theory  gave  place  to  the  notion  that, 
though  the  defect  is  not  caused  by  gross  anomalies,  yet  a 
permanent  impairment  of  the  nervous  system  is  present. 
Kussmaul  holds  consistently  (86)  to  the  view  that  stuttering 
is  a  "  spastic  co-ordination  neurosis."  This  view  is  adhered 
to  by  many  modern  writers,  especially  by  those  who  approach 
the  subject  from  the  medical  point  of  view.  Gutzmann 
(66;  211)    holds   that   every   stutterer   is   neuropathically  af- 

de  di  on  eet  a  te  e  edde,  te  ut  te  da  oue  dade  ded,  e  didde  oue  tetedde 
a  ne  ahdin  to  te  tetedde  adase  ut,  ne  no  te  tetate,  ninne  ut  enu,  to  I 
ah  te  nini,  pone  e  dordy,  to  edde  e  edde,  Ame." 

3  Scripture,  in  his  recent  book,  Stuttering  and  Lisping  (New  York, 
1912,  251  pp.),  written  subsequently  to  the  completion  of  this  paper, 
has  attempted  to  change  the  meaning  of  the  term  "  lisping  "  to  include 
defects  that  are  usually  classified  as  stammering.     See  pp.  iii  ff. 


h 


206  FLETCHER 

flicted.  Scripture  claims  (125)  that  "stuttering  is  a  distinct 
form  of  nervous  disease  ...  ;  it  can  be  properly  and  legally 
treated  only  by  a  physician." 

There  is,  however,  a  tendency  among  many  medical  authori- 
ties to  lay  chief  stress  upon  the  mental  aspects  of  the  phe- 
nomenon, so  that  the  third  stage  in  the  progress  of  its  diag- 
nosis may  be  said  to  be  the  one  in  which  mental  rather  than 
physical  conditions  are  regarded  as  primary,  Makuen,  for 
example  (103),  says  that  *' many  persons  stammer  (stutter) 
under  certain  conditions,  largely  because  they  think  they  will. 
All  their  past  experiences  with  speech  have  combined  to  con- 
firm them  in  the  thought  and  it  soon  becomes  a  sort  of  "  fixed 
idea."  Langwill  (88)  believes  that  "stammering  (stuttering) 
is  essentially  a  functional  affection, — a  neurosis,  the  result  of 
the  defective  working  of  the  complex  co-ordinated  mechanism 
concerned  in  the  production  of  speech,  and  not  a  defect  of 
structure.  Pathological  lesions,  therefore,  need  not  be  looked 
for."  Gutzmann,  in  spite  of  his  agreement  with  Kussmaul, 
as  indicated  above  (p.  205),  says  (59):  "In  the  psychology 
of  stuttering  we  do  not  find  the  destruction  of  any  separate 
fibres  or  special  centers ;  also  the  connection  between  the  sen- 
sory center  and  the  ideational  centers,  on  the  one  hand,  and 
the  motor  center,  on  the  other,  are  undisturbed.  The  stutterer 
simply  does  not  succeed  in  making  the  co-ordination  from  the 
motor  center  to  the  organs  well  enough  to  produce  the  correct 
mutual  functioning." 

III.    Physiological 

Physiologically  the  function  of  speech  involves  the  co-ordi- 
nated action  of  the  three  musculatures  of  (i)  breathing,  (2) 
vocalization,  and  (3)  articulation.  The  aberrations  from  the 
normal,  that  are  found  in  the  stutterer's  speech,  in  respect  to 
these  three  functions,  will  be  taken  up  in  order. 

A.  Breathing 

a.  Historical.  Until  the  methods  of  observation  and  pal- 
pation had  given  place  to  the  use  of  instruments,  such  as  those 
devised  by  Marey,  Bert,  Zwaardemaker,  Rousselot  and  others 
(59),  exact  study  of  these  functions  was  impossible.  With 
some  exceptions  the  earlier  studies  of  breathing  were  pri- 
marily physiological ;  and  they  largely  disregarded  the  mental 
influences  which  are  taken  into  account  by  such  studies  as 
those  by  Mentz  (105)  and  Zoneff  and  Meumann  (149). 
Before  abnormalities  could  be  indicated  it  was  necessary  to 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  207 

establish  the  simpler  facts  of  normal  breathing,  such  as  the 
difference  between  rest-breathing  and  breathing  during  speak- 
ing; the  relations  between  thoracic  and  abdominal  breathing, 
and  the  like.  Halle,  who  recognizes  the  influence  of  mental 
states  on  breathing,  but  who  does  not  attempt  a  definite  cor- 
relation, was  one  of  the  earliest  investigators  in  this  field  (73). 
He  found  in  the  stutterer: 

1.  Tonic  or  clonic  spasms  of  the  diaphragm  in  all  cases; 

2.  Psychical  alterations  of  the  breathing  curve  both  before 
and  after  speaking; 

3.  Poor  economy  of  breathing; 

4.  Attempts  at  speaking  during  inspiration ; 

5.  Withholding  of  the  breath  after  speaking. 
Gutzmann    (66)    originally  accepted  the  findings  of  Halle 

but  has  subsequently  changed  his  opinion.  His  more  recent 
conclusion  (66;  202)  is  that  if  one  would  avoid  error  one 
should  disregard  the  influence  of  mental  states  on  breathing 
changes  altogether.  This  conclusion,  however,  seems  in  turn 
to  be  modified  by  his  admission  that  certain  states  of  mind 
can  have  an  effect  on  breathing  (64;  16).  To  admit  that  this 
is  an  unsettled  question  would  have  an  important  bearing 
upon  the  problem  in  hand,  for,  if  mental  states  have  no  influ- 
ence on  the  breathing,  stuttering,  in  so  far  as  it  is  a  disturb- 
ance of  breathing,  must  be  essentially  physiological. 

Ten  Gate,  who  was  the  first  to  make  simultaneous  records 
of  thoracic  and  abdominal  breathing-curves,  found  (18)  that 
the  stutterer  is  not  below  the  normal  in  chest  expansion; 
and  that,  though  his  expiration  period  is  shorter  than  the 
normal,  his  lung  capacity  is  not  below  the  average.  How- 
ever, he  finds  that  the  stutterer's  strength  of  inspiration  is 
greater  than  that  of  expiration,  which  is  the  reverse  of  the 
condition  found  with  the  normal  speaker.* 

There  are  no  complete  statistics  on  the  number  of  male  and 
female  stutterers;  but  estimates  (24;  362  ff.)  show  that  male 
stutterers  preponderate  over  females  in  ratios  ranging  from 

*  This  last  finding  would  seem  to  point  to  some  permanent  physio- 
logical difference  that  is  characteristic  of  the  stutterer.  As  bearing 
upon  this  point  it  is  of  interest  to  quote  certain  findings  mentioned 
by  Greene  (44).  Greene  reports  that  in  cases  of  forced  breathing  the 
strength  of  inspiration  of  women  is  60  per  cent,  of  that  of  men,  and 
that  of  expiration  is  66.7  per  cent. ;  that  in  quiet  breathing  the  strength 
of  the  inspiration  66.7  per  cent,  of  that  of  men,  and  that  of  expiration 
is  63.25  per  cent.  In  all  cases,  therefore,  women  are  inferior  to  men 
in  strength  of  respiration.  Yet  there  are  several  times  as  many  male 
stutterers  as  female.  Strength  of  respiration,  therefore,  does  not  seem 
to  be  a  determining  causal  factor. 


208  FLETCHER 

2:1  to  10:1.  The  male  preponderance  is  much  greater  in 
childhood  than  it  is  in  adulthood;  psychological,  physiological, 
and  sociological  differences  between  the  sexes  have  been 
pointed  out  as  causes  of  this  preponderance.  Differences  in 
breathing-types  have  been  most  frequently  suggested.  That 
there  are  sex  differences  in  this  regard  seems  to  be  granted ; 
it  is  held,  however  (^y),  that  such  differences  are  not  con- 
genital but  are  due  to  the  habit  of  constriction.^ 

b.  Subjects.  L.  R.  is  a  boy  fifteen  and  a  half  years  old, 
who  dropped  out  of  school  while  in  the  sixth  grade  because 
of  his  inability  to  talk.  He  is  in  good  health,  is  well  grown 
and  well  nourished.  He  is  cheerful,  energetic  and  of  normal 
mentality.  He  began  to  stutter  at  the  age  of  two  without 
any  known  cause. 

E.  B.  is  a  boy  in  the  eighth  grade  of  the  public  school,  and 
in  spite  of  his  difficulty  is  making  normal  progress  in  his 
studies.  He  is  healthy  and  of  normal  intelligence;  his  here- 
dity, so  far  as  could  be  ascertained,  was  negative  for  all  that 
could  be  considered  to  form  a  neuropathic  basis  for  his  defect. 

F.  Q.  is  a  boy  17  years  old,  of  good  intelligence,  and  of 
pleasing  manner.  He  has  had  for  some  years  a  valvular  dis- 
order of  the  heart.  His  stuttering  was  said  to  have  originated 
in  an  experience  of  fright.  While  playing  on  the  street  at 
the  age  of  six  he  was  accosted  by  a  man  who  he  now  thinks 
must  have  been  insane,  and  who  asked  to  be  directed  to  a 
certain  place,  s  When  the  boy  attempted  to  show  him  the 
man  grasped  him  by  the  hand,  dragged  him  into  some  tall 
grass  and  left  him.  When  the  man  went  away  the  boy  es- 
caped and  has  stuttered  since  that  experience. 

P.  A.  is  a  boy  14  years  old,  normally  intelligent,  and  in 
good  health.  He  is  somewhat  rough,  indifferent,  headstrong, 
and  unreliable.  There  are  no  significant  facts  of  heredity, 
nor  is  the  history  of  the  origin  of  his  defect  known. 

A.  N.  is  a  young  man  22  years  of  age,  of  good  intelligence, 
cheerful  and  friendly.  He  has  good  business  qualities,  and  is 
of  good  habits.  His  heredity  is  negative,  and  the  history  of 
the  origin  of  his  defect  is  unknown.     His   stuttering  is  of 

^  If  permanent  breathing-differences,  due  to  constriction,  are  respon- 
sible for  the  differences  in  the  numbers  of  male  and  female  stutterers 
it  would  seem  that  where  customs  of  tight-lacing  do  not  exist  there 
should  be  no  such  marked  differences.  As  bearing  upon  this  point 
the  writer  secured  from  Japan  statistics  concerning  the  prevalence  of 
stuttering  among  135,852  boys  and  20,637  girls.  These  statistical  data 
show  approximately  the  same  sex  differences  as  are  found  in  other 
countries.  In  one  prefecture  (Yamaguchiken)  5.06  per  cent,  of  the 
boys  are  stutterers  while  only  .16  per  cent  of  the  girls  stutter. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  209 

severe  degree;  he  is  often  unable  to  think  of  what  he  is 
trying  to  read  when  stuttering.  His  mind  seems  to  become 
befogged  under  those  conditions,  and  only  the  memories  of 
feelings  and  strains  are  left  behind.  Even  when  not  attempt- 
ing to  speak  he  reports  that  conditions  of  what  appear  to 
be  "  blank  abstraction  "  come  over  him. 

W.  N.  is  a  boy  12  years  of  age,  and  is  the  son  of  a  stut- 
terer. The  father  reports  that  he  himself  acquired  the  defect 
by  imitating  a  school-mate  who  stuttered.  The  boy  is  re- 
garded by  his  teacher  as  being  one  of  the  best  students  in 
the  school.  He  is  in  good  health.  In  his  stuttering  he  shows 
a  tonic  closing  of  the  lips,  the  bottom  lip  pressing  against 
the  inner  side  of  his  upper  teeth,  while  the  chin  is  in  a  tremor. 
In  reading,  his  eyes  run  ahead  to  detect  the  difficult  words. 

H.  A.  is  a  young  man  24  years  of  age  who  dropped  out  of 
high  school  on  account  of  his  defect.  His  stuttering  began  in 
the  fourth  grade,  and  is  attributed  to  the  act  of  imitating  a 
school-mate.  He  is  intelligent,  active,  competent ;  he  is  the  son 
of  a  physician,  and  he  has  excellent  training  as  a  machinist. 
His  health  is  good,  and  his  heridity  is  negative.  His  stuttering 
is  worse  in  conversation  than  in  reading  aloud.  Talking  over 
the  telephone  is  easier  for  him  than  any  other  form  of  speech. 
His  stutter  movements  are  strongly  suppressed,  being  confined 
to  the  opening  and  closing  of  the  mouth  while  the  tongue  is 
adhering  to  the  roof  of  it.  Certain  consonants  give  him  much 
difficulty. 

/.  L.  is  a  young  lady  of  18,  who  is  in  the  third  year  of 
the  high  school.  On  account  of  protracted  illness,  she  lost 
considerable  time  from  school  while  in  the  grades.  On  re- 
turning, she  was  nervously  anxious  to  keep  up  with  her  class ; 
and  her  stuttering  began  during  this  period.  She  reports 
that  when  she  realizes  that  she  is  going  to  be  called  upon  by 
her  teacher  to  recite,  her  heart  beats  violently.  In  addition  to 
the  stutterer's  usual  ability  to  sing  she  also  possesses  the 
ability,  not  uncommon  among  stutterers,  to  speak  in  public 
and  to  participate  in  amateur  theatricals  without  fear  of  stut- 
tering. Her  stuttering  is  confined  to  certain  consonants,  of 
which  she  is  in  dread.  She  too  runs  ahead  in  her  reading 
to  see  if  difficult  letters  are  ahead  of  her. 

H.  D.  is  a  young  man,  aged  21,  who  began  stuttering  at 
the  age  of  5  by  imitating  a  cousin.  He  is  in  good  health,  and 
is  physically  and  mentally  vigorous.  He  was  one  of  the  best 
debaters  in  his  high  school,  and  was  the  orator  of  his  class 
on  graduation.  Under  the  stimulus  of  speaking  in  public, 
he  does  not  stutter,  while  in  private  conversation  he  is  often 


210  FLETCHER 

unable  to  make  himself  understood.  His  stutter  movements 
consist  of  clinching  the  jaws  and  holding  them  in  tonic  condi- 
tion until  a  violent  explosion  of  the  attempted  sound  takes 
place.  Often  his  mouth  will  open  widely  without  effecting 
the  sound  desired. 

The  greater  part  of  the  data  for  the  present  study  was  se- 
cured from  these  nine  subjects.  Many  other  stutterers  were 
examined,  from  whom  we  obtained  a  limited  number  of  rec- 
ords bearing  on  certain  points. 

c.  Method.  The  subjects  were  seated  comfortably  in  a 
chair  by  the  side  of  the  table  upon  which  stood  the  register- 
ing instruments ;  the  instruments  were  hidden  from  view  by 
a  screen.  Extraneous  noises  and  other  distractions  were  re- 
duced to  a  minimum.  Time-lines  were  recorded  by  means 
of  a  Jacquet  chronometer.  The  apparatus  was  so  ar- 
langed  that  the  experimenter  could  manipulate  it  without 
moving  from  his  seat,  or  being  seen  by  the  subject.  For  tak- 
ing the  breathing  curves  two  Sumner  pneumographs  were 
used,  one  being  placed  about  the  thorax  and  the  other  about 
the  abdomen.  The  registrations  were  made  by  Marey  tam- 
bours on  smoked  paper  attached  to  the  drum  of  a  kymograph. 
Signal  keys  connected  with  the  kymograph  by  means  of  tam- 
bours were  used  to  indicate  when  the  subject  was  endeavoring 
to  speak.  Cards  on  which  were  printed  various  selections  of 
prose  and  poetry  were  used  as  material  for  speech.  When 
these  failed,  as  they  sometimes  did,  to  evoke  stuttering,  the 
subject  was  asked  to  relate  in  his  own  language  the  substance 
of  something  he  had  read  or  to  give  an  account  of  something 
with  which  he  was  known  to  be  familiar.  If  this  failed, 
strangers  were  brought  into  the  room  and  the  effects  noted. 

Attention  must  be  called  to  the  fact  that,  while  in  these 
experiments,  methods  of  registration  must  remain  constant, 
the  stimulus  used  to  provoke  stuttering,  which  is  the  phe- 
nomenon to  be  studied,  cannot  remain  constant  for  the  ob- 
vious reasons  that  the  same  stimulus  will  not  produce  stutter- 
ing in  all  individuals,  and  that  the  same  stimulus  will  not 
produce  constant  effects  in  the  same  individual. 

Strictly  speaking  the  asynergies  of  vocal  utterance  would 
include  the  disordered  action  of  each  musculature  taken  by 
itself,  and  in  its  relation  to  the  other  two  musculatures  (See 
p.  206.)  In  the  study  of  breathing  our  chief  emphasis  will  be 
put  on  the  first  aspect;  whereas  in  \ocalization  and  articula- 
tion it  has  been  necessary  for  reasons  to  be  indicated  later  to 
give  chief  emphasis  to  the  second  aspect. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  211 

d.  Results.  In  general  it  has  been  found  that  stutterers  ' 
present  no  permanent  peculiarities  of  breathing  unrelated  to 
the  function  of  speaking.  This  is  in  accord  with  the  findings 
of  ten  Gate  (i8)  and  contrary  to  those  of  Gutzmann  (66). 
It  must  further  be  said  that  there  are  apparently  as  many 
varieties  of  breathing  peculiarities  among  stutterers  as  there 
are  varieties  of  stuttering. 

Detailed  measurements  of  the  breathing-curves  were  made 
by  using  a  line  drawn  in  the  direction  of  the  movement  of 
the  drum  to  be  used  as  a  line  of  reference  from  which  meas- 
urements were  made  in  millemeters  to  a  point  midway  be- 
tween the  top  of  the  expiration  and  the  bottom  of  the  inspi- 
ration curves.  These  measurements  show  that  the  mean 
variations  and  the  averages  are  characteristically  greater  in  the 
breathing-curve  during  stuttering  than  during  normal  speech. 
The  total  results  of  the  cases  measured  are  as  follows : 


Normal  Speaking 


Stuttering 


fi.  Av.     26.2    mm. 

[2.M.V.   3.79   ." 
fi.  Av.     35.6    mm. 


L2.M.V.    4.62    " 

The  arhythmic  character  of  breathing  is  evident  from  these 
data. 

Many  peculiarities  of  the  curves,  however,  are  minute;  and 
do  not  lend  themselves  to  tabular  statement.  (See  Plates.) 
The  characteristic  aberrations  may  be  grouped  in  three  general 
classes : 

1.  Retardations 

2.  Total  misplacements 
J.  Interruptions 

These  are  characteristic  both  of  inhalation  and  of  exhalation. 
/.  Retardation  means  the  withholding  of  inhalation  beyond 
the  average  time,  and  the  attempt  to  speak  when  the  lungs 
are  comparatively  empty.  Exhalation  may  also  be  withheld; 
but  this  is  not  so  characteristic.  Exhalation  for  the  stutterer 
is  apparently  more  easily  performed  than  inhalation;  but  it 
does  not  always  result  in  the  production  of  sound.  Many 
cases  show  complete  exhalation  before  the  production  of 
sound.  In  one  case  exhalation  lasted  eight  seconds  yet 
the  attempt  at  sound  was  vain.  Exhalation  is  aften  inter- 
rupted by  short,  spasmodic  inhalations.  2.  Total  misplace- 
ment means  the  complete  breaking  up  of  the  natural  rhythm 


212  FLETCHER 

to  the  extent  that  inhalation  occurs  where  exhalation  should 
take  place  or  vice  versa,  j.  Interruption  may  occur  in  two 
ways ;  o.  inhalation  may  be  broken  into  by  exhalation ;  or 
b.  exhalation  may  be  broken  into  by  inhalation.  These 
forms  are  frequently  found;  the  speech  accompanying  such 
breathing  is  characterized  by  broken,  jerky  blurts  of  speech, 
appearing  frequently  in  the  form  of  repetition  of  the  initial 
syllable  of  a  word. 

A  study  of  the  ratio  of  the  time  of  inspiration  to  that  of 
expiration  was  also  attempted  with  the  following  results :  On 
computing  the  averages  of  the  records  of  each  individual,  and 
then  the  average  of  these  individual  averages,  it  was  found 
that  the  fraction  representing  the  inspiration-time  divided  by 
the  expiration-time  during  normal  speaking  was  .217  sec, 
whereas  in  stuttering  it  was  .535  sec. ;  or,  otherwise  stated, 
the  ratio  of  inspiration  to  expiration  was  found  to  be  more 
than  twice  as  great  in  stuttering  as  in  normal  speech.  Stated 
in  other  terms  it  appears  as  follows : 

Inspiration  :  expiration  :  :  217  :  1000  in  normal  speech; 
"  :         "  :  :  535    :  1000  "  stuttering. 

Since  the  date  of  ten  Gate's  investigations  (18),  consider- 
able emphasis  has  been  placed  upon  the  temporal  relations 
between  the  thoracic  and  the  abdominal  curves.  These  rela- 
tions have  been  expressed  by  such  general  terms  as  "  ahead," 
"  behind,"  "  synchronous,"  and  "  anachronous."  These  terms 
are  found  to  be  inexact  for  tabulating  results  for  the  reason 
that  if.  for  instance,  we  take  the  top  of  the  abdominal  curve 
it  may  be  (i)  ahead,  (2)  behind,  (3)  synchronous  with,  or 
(4)  in  opposite  phase  with  the  top  of  the  thoracic  curve  if 
we  use  the  latter  as  a  curve  of  reference.  Similarly,  the  bot- 
tom of  the  abdominal  curve  may  sustain  four  relations  to  the 
bottom  of  the  thoracic  curve.  Our  tabulated  results  show 
that  many  records  are  characterized  throughout  by  the  fact 
that,  during  speaking,  the  crest  of  the  abdominal  curve  is 
behind,  while  the  bottom  is  ahead ;  whereas  in  rest  there  had 
been  complete  synchronism. 

The  following  were  compiled  from  typical  cases  of  breath- 
ing curves  of  stutterers  in  an  attempt  to  determine  whether 
any  definite  temporal  relationship  could  be  established  be- 
tween the  thoracic  and  the  abdominal  curves.  In  each  case 
the  thoracic  curve  is  compared  with  the  abdominal.  Two 
points  of  the  thoracic  curve  are  taken,  namely,  the  crest  and 
the  trough,  and  these  two  points  are  compared  with  the  two 
corresponding  points  on  the  abdominal  curve.    Each  of  these 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING 


213 


TABLE  I. 

(Crest.)    Subject  L.  R. 

Showing  the  temporal  relation  which  the  thoracic  curve  may  sustain 
to  the  abdominal.  The  figures  in  the  various  columns  of  the  table  indicate 
the  number  of  times  the  temporal  relationship,  designated  at  the  top  of 
the  column,  occurs  in  the  record  whose  number  appears  in  the  extreme 
left-hand  column. 


No.  OF 
Record 

Ahead 

Behind 

Synchronous 

Opposite 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

1 

.... 

2 

13 
9 

21 
8 
9 
1 
6 
1 
1 
4 
8 

18 

4 

i 
io 

2 

i 

1 

8 

1 

"2 
5 
2 
6 

"s 

8 

1 

13 

25 

1 
3 

i 

45 

6 

4 

6 

36 

31 

12 

1 

"23" 
7 
2 
2 

"2 
2 
1 

2 

3 

4 

5 

9 

6 

7 

8 

9 

10 

11 

12 

Totals 

4 

2 

99 

28 

65 

145 

40 

TABLE  L 

(Trough.)    Subject  L.  R. 

Showing  the  same  as  Table  I  above,  but  using  the  trough  instead  of 
the  crest  of  the  thoracic  curve  as  a  point  of  comparison. 


No.  OF 
Record 

Ahead 

Behind 

Synchronous 

Opposite 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

1 

1 

"6 
1 
1 

"2 
2 
3 

io' 

'2 
2 

12 
■3 

10 

8 

11 

1 
24 

■4" 
2 
1 

■5' 
9 

2 

i 

'2 

■4 

'2 
3 

1 
3 
2 
3 
2 
1 
3 
4 
1 
9 
1 
22 

1 
1 

6 
45 
5 
2 
6 
19 
34 
11 

.... 

"6 

17 

"2 

'"i" 

4 

2 

3 

4 

5 

5 

6 

3 

7 

8 

9 

10 

11 

1 

12 

Totals 

26 

19 

75 

14 

52 

130 

31 

9 

214 


FLETCHER 


points  on  the  thoracic  curve  can  sustain  four  general  tem- 
poral relations  to  the  corresponding  points  on  the  abdominal 
curve.  These  relations  are,  i.  ahead,  2.  behind,  3.  synchro- 
nous, 4.  opposite  in  phase.  The  numbers  of  the  record  ap- 
pear in  the  left  hand  column.  The  figures  in  the  other  col- 
umns of  the  table  indicate  the  number  of  times  the  temporal 
relation,  designated  at  the  top  of  the  column,  occurs  in  the 
record  whose  number  appears  at  the  left. 


TABLE  II. 

(Crest.)    Subject  F.  Q. 

Showing  the  same  as  Table  I  above  (page  213)  with  a  different  subject. 


No.  of  Record 

Ahead 

Behind 

Synchronous    ( 

Dpposite 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest  Sp 

eaking 

Rest 

1 

.... 

"2 
"2 

.... 

i 
i 

19 

9 

11 

9 

25 

9 

8 

8 

4 

6 

8 

6 

8 

5 

5 

2 

24 

13 

11 

12 

12 

15 
23 
15 
5 
7 
14 

"i 
5 
1 

■3 
'2 

"2 
.... 

"2 

"8 

.... 

1 
2 
2 
2 

"4' 

"2 

ie 

ii 
2 

1 

■5 
2 
4 

i 
5 

i 

1 
3 

i" 

1 

i' 

'5' 
2 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

Totals 

6 

2 

214 

91 

27 

48 

15 

• 

• 

Tables  I,  II,  and  III  show  the  following  characteristics : 

1.  The  temporal  relations  of  the  crest  of  the  two  curves 
do  not  agree  with  the  temporal  relations  of  the  bottom.  (Cf., 
e.  g.,  the  crest  and  trough  of  Table  II.) 

2.  The  character  of  the  breathing  curve  varies  with  the 
individual.     (Cf.,  e.g.,  the  totals  of  Tables  I,  II,  and  III.) 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING 


215 


TABLE  11. 

(Trough.)    Subject  F.  Q. 

Showing  the  same  as  Table  II  above,  but  using  the  trough  instead  of 
the  crest  of  the  thoracic  curve  as  a  point  of  comparison. 


No.  of  Record 

Ahead 

Behind 

Synchronous 

Opposite 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

1 

5 

"4 
2 
1 
2 
7 

12 
6 
4 
4 
4 

10 
8 
7 

22 
8 
6 
8 
8 

'4 
1 

'i 
"i 
'2 
"i 
"i 

"8 

"5 

11 

7 

3 

.... 

"2 
.... 

"3' 

1 
4 
3 

12 

6 

14 

12 

is 
'i 

10 

3 

11 

"2 

"3 
2 

"4 
.... 

.... 

7 
10 

5 
10 
10 

2 

1 

'4 
3 
3 
3 

'i 

1 

"i 
3 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

Totals 

128 

11 

49 

58 

37 

64 

3.  The  individual  records  of  each  subject  present  marked 
peculiarities  at  certain  times.  (Cf.,  e,  g.,  record  6,  Table  I, 
trough.) 

The  abdominal  curve  usually  shows  sHghter  fluctuations 
than  the  thoracic.  The  former  frequently  assumes  a  tonic 
condition,  which  has  often  been  described  as  "  cramp  "  though 
certain  objections  have  been  raised  (74)  to  the  use  of  this 
term.  In  many  cases  the  thoracic  and  abdominal  curves 
tended  to  approach  each  other,  often  to  the  point  of  touch- 
ing ;  and  this  would  sometimes  continue  throughout  the  speak- 
ing interval. 

With  certain  subjects  (one  in  particular,  L.  R.)  there  was 
found  on  certain  days  a  complete  point-for-point  opposition 
of  phase,  such  as  Janet  (81 ;  256)  found  to  exist  in  hysterical 
paralysis  of  the  diaphragm.  This  phenomenon  appeared  dur- 
ing the  speaking  interval  only. 


216 


FLETCHER 


TABLE    in. 

(Crest.)    Subject  E.  B. 

Showing  the  same  as  Table  I  above  (  page  213),  with  a  different  subject. 


Ahead 

Behind 

Synchronous 

Opposite 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

1 

.... 

1 

17 
10 
17 
13 
13 
15 
22 

24 
10 
12 
11 
9 
18 
23 

"i' 

"6 
3 

9 

5 

1 

.... 

2 

3 

4 

5 

6 

7 

Totals 

1 

1 

107 

107 

13 

15 

1 

TABLE  in. 

(Trough.)    Subject  E.  B. 

Showing  the  same  as  Table  III  above,  but  using  the  trough  instead  of 
the  crest  of  the  thoracic  curve  as  a  point  of  comparison. 


Ahead 

Behind 

Synchronous 

Opposite 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

Speaking 

Rest 

1 

"6 

"5 
1 

8 

6 

18 

'4 

12 
7 
1 

13 

28 
1 

16 

9 

io 

22 

"3 

2 

.... 

8 
2 

6 
9 
3 
3 

14 

1 

2 

3 

4 

5 

6 

7 

Totals 

12 

36 

78 

41 

16 

36 

.... 

The  thoracic  seems  to  be  more  sensitive  to  mental  disturb- 
ance than  the  abdominal  curve.  The  latter  sometimes  remains 
stationary  while  the  thoracic  curve  shows  a  uniform  upward 
tendency  or  else  considerable  fluctuation. 

In  many  cases  breathing  disturbances  appear  before  the 
speaking  interval,  and  also  subsequent  to  it.  These  after- 
period  disturbances  have  continued  as  long  as  eight  seconds. 

Breathing  abnormalities  seem  to  tend  toward  becoming 
stereotyped  in  certain  forms  for  certain  individual  stutterers. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  217 

These  individual  peculiarities  are  numerous  and  varied  in 
character.  They  often  appear  as  temporarily  adopted  expe- 
dients to  help  out  in  the  beginning  of  speech,  just  as  the  stut- 
terer will  often  be  found  to  start  himself  speaking  by  utter- 
ing a  vowel  sound  like  "  ah."  Breathing  peculiarities  of  this 
kind  are  too  numerous  and  varied  to  admit  of  classification.* 

B.  Vocalization 

a.  Method.  The  abnormalities  of  vocalization  do  not  ^ 
admit  of  being  studied  in  isolation  from  the  other  physiologi- 
cal processes  of  speech  as  well  as  those  of  breathing.  The 
aberrations  to  be  studied  under  this  heading  will  be  the  asyner- 
gies between  vocalization  and  the  other  processes  of  speech, 
particularly  that  of  breathing.  This  seems  to  be  one  of  the 
most  characteristic  physiological  manifestations  of  stuttering. 
The  writer  is  not  aware  of  any  other  attempt  to  study  the 
relation  between  breathing  and  vocalization  except  by  the  use 
of  the  signal  key,  which  is  an  inaccurate  method. 

It  was  not  thought  necessary  for  the  present  study  to  secure 
minute  records  of  the  pitch  and  quality  of  the  voice.  It  was 
deemed  sufficient  to  employ  an  apparatus  which  would  faith- 
fully record  when  the  voice  was  sounding,  and  which  at  the 
same  time  would  not  be  responsive  to  the  breath.    After  the 

'  Gutzmann's  classification  of  breathing  abnormalities  is  as  follows : 

1.  Primary  disturbances 

a.  Too  frequent  inspirations ;  b.  prior  postponement ;  c.  clonic 
and  tonic  spasms ;  d.  temporal  opposition  of  costal  and  abdominal 
breathing. 
II.     Secondary  disturbances 

a.  Spasms  of  breathing  dependent  upon  spasms  of  the  organs 
of  articulation. 
The  writer  has  found  examples  of  all  of  the  above  disturbances,  and 
in   addition   has  found   disturbances  which  may  be  classified  as  the 
opposite  of  I,  a.  and  h. 
Ten  Gate  (i8)  finds: 

/.  That  rest-breathing  curves  of  the  stutterer  are  like  those  of  the 
normal  person. 

2.  Disturbances  of  speech-breathing  are  always  present  in  speech 
defects. 

3.  The  normal  anachronism  of  speaking-breathing  is  broken  up  in 
case  of  the  stutterer. 

4.  Inspiration  curves  are  steeper  in  the  stutterer  than  in  the  normal 
individual. 

The  writer's  findings  corroborate  points  i,  2,  and  4,  but  not  3.  The 
findings  reported  above  have  not  agreed  with  the  claim  that  anything 
like  a  permanent  synchronism  between  costal  and  abdominal  breath- 
ing is  to  be  found  in  the  speech  of  the  stutterer. 


218  FLETCHER 

trial  of  several  instruments  the  Rousselot  microphone  was 
found  to  be  best  suited  to  our  purpose.  The  breathing  records 
were  made  simultaneously  with  the  voice,  and  on  the  same 
kymograph.  It  was  therefore  necessary  for  the  drum  to  turn 
slowly ;  hence  the  stylus  connected  with  the  microphone  shows 
only  a  rapid  up-and-down  movement  during  the  period  of 
vocalization. 

b.  Results.  It  is  to  be  remembered  that  the  characteristic 
normal  rest-breathing  curve  shows  inspirations  and  expira- 
tions of  approximately  the  same  length,  and  that  the  thoracic 
and  the  abdominal  curves  are  approximately  synchronous  in 
phase.  When  normal  speech  begins,  the  expiration  period  is 
greatly  lengthened  and  the  inspiration  period  is  greatly  short- 
ened. Also  normal  speech  shows  vocalization  at  the  initial 
point  of  expiration.  Radical  departures  from  these  conditions 
occur  in  the  stutterer's  speaking  interval.  Parallel  with  the 
misshapen  breathing  curves,  already  discussed,  the  micro- 
phone enables  one  to  locate  and  measure  the  periods  of  vocali- 
zation. The  aberrations  so  far  noted  are  of  two  general 
kinds :  /.  misplacement,  and  2.  faulty  utilization  of  voice. 
Under  i.  will  appear  frequent  cases  in  which  the  subject  is 
found  to  be  vocalizing  when  both  his  thoracic  and  abdominal 
curves  indicate  inspiration,  and  still  again  when  his  thoracic 
and  abdominal  curves  are  out  of  phase. 

It  may  almost  be  said  that  faulty  utilization  is  invariably 
present.  This  lends  itself  to  a  sort  of  quantitative  statement. 
By  the  selection  of  a  series  of  type  cases  from  normal  and 
abnormal  speaking,  the  following  averages  were  secured :  In 
the  abnormal  type,  the  expiration  interval  averaged  24.6  sec- 
onds. The  vocalization  interval  occupied  9  seconds  of  this, — 
which  means  that  36.5  per  cent,  of  the  expiration  interval 
was  utilized  in  vocalization.  The  rest  of  this  interval  was 
taken  up  by  aphonic  disturbances  such  as  are  shown  by  the 
pneumograph. 

The  normal  records,  on  the  other  hand,  showed  that  of 
an  average  expiration  interval  of  26.8  seconds,  25.6  were  util- 
ized in  vocalization.  Or  with  normal  speaking  there  appears  an 
efficiency  of  90  per  cent.,  as  compared  with  an  efficiency  of 
36.5  per  cent,  in  the  case  of  the  abnormal.''' 

'  It  may  be  said  that  the  voice  of  the  stutterer  often  seems  to  the 
auditor  to  be  husky  and  suppressed, — indicating  a  tension  of  the  throat 
muscles,  and  an  improper  functioning  of  the  muscles  in  control  of 
the  vocal  cords.  The  husky  sounds  of  the  stutterer's  voice  often  gives 
one  the  impression  of  the  voice  of  fear. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  219 

C.  Articulation 

d.  Method.  By  asynergies  in  articulation  will  be  meant 
here  the  disharmonies  between  the  action  of  the  muscles  of 
articulation  and  those  of  vocalization.  This  disharmony  is 
regarded  as  one  of  the  most  important  manifestations  of  stut- 
tering. Since  instruments  attached  to  the  lips,  teeth,  etc.,  of 
the  subject  will  register  the  facial  contortions  which  are  char- 
acteristic of  many  stutterers,  and  thus  interfere  with  the 
study  of  the  actual  processes  of  articulation,  the  writer  has 
felt  the  need  of  an  apparatus  sufficiently  delicate  to  record 
the  sound  of  the  vocalized  consonants  and  at  least  to  indicate 
the  location  on  the  voice  records  of  the  mutes  such  as  the 
explosives,  fricatives,  etc.,  in  addition  to  showing  the  pitch,  s^ 
intensity  and,  if  possible,  the  quality  of  the  vocal  sounds. 

At  Stanford  University  and  subsequently  at  Clark  Univer- 
sity more  than  a  year  was  devoted  to  experiments  with  the 
Marbe  smoke-ring  apparatus  in  the  hope  that  it  could  by  some 
improvements  be  made  to  serve  our  purposes.*  The  attempt 
to  use  this  apparatus  was  abandoned  for  the  following  rea- 
sons: I.  It  can  only  register  pitch, — the  amount  of  deposit 
on  the  paper  is  not  a  reliable  measure  of  intensity ;  2.  the 
rapid  motion  of  the  kymograph  was  a  source  of  distraction 
to  the  subjects  and  made  lengthy  records  difficult  to  procure; 
j.  consonantal  sounds  cannot  be  recorded  by  this  means.  The 
flame  is  inclined  to  flare  out  from  the  drum  especially  when 
explosive  consonants  are  pronounced;  an  important  point  in 
the  study  of  the  stutterer's  voice  is  thereby  lost.^ 

8  This  apparatus  consists  of  an  arrangement  by  which  an  acetylene 
flame,  set  in  motion  by  the  vibrations  of  the  air-waves  against  a  cur- 
rent of  gas  that  passes  by  a  rubber  diaphragm  in  a  manner  similar 
to  that  seen  in  the  Koenig-flame  apparatus  plays  upon  the  drum  of 
a  kymograph  which  receives  deposits  of  soot  (smoke-rings)  according 
to  the  pitch  of  the  sound. 

^  An  attempt  was  made  to  obviate  some  of  these  difficulties  by  the 
use  of  various  sorts  of  diaphragms.  One  attempt  at  improvement 
consisted  in  the  substitution  of  a  telephone  disc  for  the  rubber  diaph- 
ragm. A  brass  cap  was  fitted  over  an  ordinary  telephone  diaphragm 
in  such  a  way  as  to  form  a  thin  air  chamber  over  it;  and  a  small 
gas  burner  was  attached  to  the  center  of  this  cap.  The  gas  was  in- 
troduced over  the  diaphragm  at  the  side.  It  was  then  possible  to 
keep  the  vibrating  body  near  to  and  at  a  constant  distance  from  the 
flame;  and  the  subject  could  be  kept  at  a  distance  from  the  distrac- 
tions of  the  apparatus.  Preliminary  tests  failed  to  show  this  to  be 
a  satisfactory  instrument  for  the  study  of  the  asynergies  of  articula- 
tion. These  difficulties  are  not  insuperable,  however,  and  it  is  planned 
to  renew  our  attempts  to  overcome  them  by  the  use  of  instruments 
like  Hensen's  phonautograph  or  Hermann's  phonophotograph  (no; 
790). 


220  FLETCHER 

b.  Results.  For  reasons  already  cited  the  writer  cannot 
here  offer  results  of  graphic  records  similar  to  those  given 
in  our  discussion  of  breathing  and  vocalization.  The  findings 
are  therefore  to  be  reported  descriptively. 

By  articulation  is  meant  the  molding  of  vowel  sounds  into 
words  or  syllables  by  the  appropriate  positions  of  the  lips, 
tongue,  teeth,  hard  and  soft  palate,  and  the  relative  openings 
of  the  nasal  and  pharyngeal  cavities.  Stutterers  (without  ex- 
ception so  far  as  the  writer  knows)  can  sing.  Singing  brings 
vocalization  into  prominence  and  reduces  articulation  to  minor 
importance.  This  fact  has  led  authorities  to  conclude  that 
the  consonant  and  not  the  vowel  is  the  source  of  the  stutterer's 
difficulties,  although  it  has  led  another  recent  writer  to  draw 
the  very  opposite  conclusion.^"  Hunt  holds  that  stutterers 
have  difficulties  with  vowels  as  well  as  with  consonants,  and 
so  does  Mr.  Isawa  of  the  Board  of  Education  of  Japan,  who 
claims  to  have  found  at  least  one  vowel  stutterer.  We  there- 
fore find  three  distinct  theories  with  reference  to  this  ques- 
tion. One  theory  holds  that  consonants  alone  are  the  source  of 
the  stutterer's  difficulty;  another  that  the  vowel  alone  is  the 
source  of  the  difficulties,  while  a  third  theory  holds  that  both 
consonants  and  vowels  are  responsible  for  the  defect. 

The  vowel  stutterers  are  generally  described  as  being  unable 
to  leave  off  certain  vowel  sounds  when  once  they  have  begun 
to  sound  them.  This  characterization  is,  in  the  opinion  of 
the  writer,  wrong  for  two  reasons:  i.  The  essence  of  stutter- 
ing consists  in  an  inhibition  of  utterance,  and  not  in  an  in- 
ability to  cease  utterance  (See  p.  205)  ;  and  2,  what  seems  to 
be  an  inability  to  cease  sounding  a  particular  vowel  is  in 
reality  an  inability  to  combine  that  vowel  with  the  succeed- 
ing consonantal  sound  to  which  the  stutterer  has  been  looking 
forward.  This  claim  is  in  harmony  with  the  well-known  law 
mentioned  by  Bonnet  (15;  52)  that  when  a  function  demands 
the  united  harmony  of  a  number  of  acts,  if  one  of  these  acts 
cannot  be  executed  (is  inhibited),  the  others  will  continue  to 
reproduce  themselves  until  the  co-ordination  of  the  move- 
ments can  finally  be  secured.  This  is  a  familiar  occurrence 
with  the  stutterer ;  it  is  seen  most  frequently  in  the  repetition 
of  the  initial  syllable  or  letter  of  a  word. 

10  Bluemel  says  (151;  v.  i;  184-185):  "The  stammerer  (stutterer) 
rarely  has  difficulty  in  singing.  But  song  differs  from  speech  chiefly 
in  the  manner  in  which  the  vowels  are  produced;  while  there  is  mani- 
festly no  radical  change  in  the  consonants.  The  absence  of  the  stam- 
merer's impediment  in  song  indicates,  then,  that  the  vowels  occasior* 
the  difficulty  in  speech." 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  221 

The  writers  who  hold  that  the  consonants  are  the  sources 
of  difficulty  for  the  stutterer  have  in  many  cases  attempted 
to  make  out  lists  of  such  consonants.  A  study  of  such  lists 
and  several  attempts  to  secure  them  from  stutterers  have  led 
the  writer  to  conclude  that  they  are  not  the  same  for  all 
stutterers,  and  that  they  do  not  remain  constant  for  the  indi- 
vidual stutterer.  Experiments  have  moreover  shown  that  if 
the  consonants  that  are  known  to  be  difficult  for  a  certain 
stutterer  are  arranged  so  that  they  appear  in  the  middle  or 
at  the  end  of  a  word,  instead  of  at  the  beginning,  the  same 
difficulty  is  not  experienced.  Stutterers  are  also  found  to  be 
able  to  whisper  without  stuttering  (the  writer  has  found  only 
one  exception  to  this).  The  writer  has  never  seen  a  case  of 
stuttering  in  the  pronunciation  of  a  vowel  that  was  wholly 
isolated  from  consonants.  He  has  tested  several  of  his  se- 
verest cases  in  this  regard  by  having  them  read  sentences  by 
eliminating  all  the  consonants  and  sounding  only  the  vowels. 
If  one  were  compelled  to  indicate  just  what  point  constitutes 
the  difficulty  for  the  stutterer  it  would  doubtless  be  nearer 
the  facts  to  say  that  the  asynergy  in  question  consists  in  the 
failure  of  vocalization  to  be  co-ordinated  with  articulation. 
This  would  point  to  the  syllable  rather  than  either  the  con- 
sonant or  the  vowel.  But  even  so  it  must  be  said  that  the 
factors  that  determine  the  difficulty  in  all  cases  seem  to  be 
not  the  nature  of  the  sounds  themselves  but  the  mental  ex- 
periences undergone  by  the  stutterer  in  his  attempts  at  pro- 
nouncing them.  Furthermore,  meaning  can  generally  not  be 
attached  to  a  single  vowel  or  consonant  but  it  can  to  a  sylla- 
ble. This,  as  will  be  shown  later  (pp.  24of.),  has  an  impor- 
tant bearing  on  the  rise  of  stuttering. 

**^ 

D.  Accessory  Movements  . 

Under  this  heading  are  grouped  the  spasmodic  radiations 
of  bodily  movements  which  accompany  stuttering  but  which 
bear  no  necessary  relation  to  the  normal  functioning  of  speech. 
These  radiations  include  both  bodily  and  facial  contortions, 
which  are  not  merely  asynergic  but  are  surplus,  unrelated, 
and  illogical  in  their  nature,  and  for  that  reason  have  been 
called  tics. 

a.  Tics.  Stuttering  has  been  defined  as  a  convulsive  tic. 
Bonnet,  however,  has  clearly  shown  the  difference  between 
the  two  phenomena  (15).  He  finds  (15 138)  that  tics  are 
often  superadded  to  stuttering,  furthermore  that  stuttering 
and  tics  are  of  common  neuropathic  stock,  and  that  one  may 


222  FLETCHER 

become  transformed  into  the  other.  They  possess  some 
marked  differences,  however.  The  number  of  persons,  for 
instance,  who  are  subject  to  tics  is  the  same  for  both  sexes, 
a  condition  which  is  not  true  in  the  case  of  stuttering.  The 
most  frequent  age  for  the  appearance  of  stuttering  is  from 
three  to  five,  the  next  most  frequent  is  from  five  to  ten.  Tics 
appear  later,  rarely  coming  before  the  fifth  year.  They  ap- 
pear most  frequently  from  six  to  ten ;  and  the  next  most  fre- 
quent time  of  onset  is  from  eleven  to  fifteen.  There  are 
tics  of  adolescence,  and  even  of  old  age,  whereas  stuttering 
is  thought  never  to  begin  after  twenty.  Stuttering  may  result 
from  imitation;  tics  do  not.  Tics  need  no  provoking  cause; 
they  appear  apropos  of  anything  or  of  nothing.  Stuttering 
movements  appear  only  during  an  attempt  to  speak.  Bonnet 
thinks  (15;  52  ff.)  that  stutter  movements  were  perhaps 
primitively  adapted  to  a  function.  Speech,  it  is  remembered, 
involves  not  only  the  articulatory  muscles  but  mimic  muscles 
as  well.  In  these  mimic  muscles  we  may  expect  compensa- 
tory reactions  which  have  the  likeness  of  tics  but  which  lack 
their  essence.  The  tic  is  a  natural  act,  a  gesture.  Stuttering 
is  a  progressive  attempt  to  speak,  which  is  thwarted  by  mus- 
cular disorder,  dyskinesia,  and  functional  asynergy.  In  stut- 
tering there  is  an  attempt  at  motor  co-ordination  for  the  pur- 
pose of  emitting  a  word  or  syllable  thought  of,  while  the 
tic  is  a  useless,  and  involuntary  movement  which  is  complete 
within  itself  though  purposeless. 

Bonnet  gives  (15;  82)  the  following  stigmata  of  ticqueurs: 
I.  psychopathic  predisposition,  2.  mental  infantalism,  j.  femi- 
nism, 4.  mental  degeneration.  He  believes  that  stutterers  pre- 
sent neuropathic  symptoms,  but  some  of  these  are  probably 
the  "  result  of  the  tribulations  of  the  life  of  the  stutterer." 
Mental  infantalism,  if  present  at  -all,  is  found  only  during 
the  school-age.  After  twelve  the  stutterer  makes  progress 
rather  above  his  age.  Feminism  is  thought  to  appear  in  young 
stutterers,  and  in  certain  cases  also  in  later  life,  particularly 
in  those  cases  that  seek  solitude.  Over  against  the  weaker 
qualities  Bonnet  cites  cases  of  "  illustrious  stutterers  "  who 
have  been  "  the  indefatigable  champions  of  the  cause  of  re- 
ligion, art  and  politics."  He  therefore  concludes  that  the 
stigma  of  degeneration  can  not  be  assigned.  By  fixation  of 
attention  a  ticqueur  may  control  or  at  least  decrease  the  vio- 
lence of  his  spasmodic  movements.  The  fixation  of  attention 
(See  p.  238)  by  the  stutterer  decreases  the  power  of  control, 
and  increases  the  violence  of  the  movements. 

Von  Sarbo  (122)  says  that  verbal  tics,  such  as  the  use  of 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  223 

"  you  know,"  "  you  see,"  "  you  understand,"  etc.,  are  espe- 
cially characteristic  of  cured  stutterers.  In  the  writer's  opin- 
ion these  are  not  true  tics  but  are  expedients  which  have  been 
purposely  adopted,  and  which  are  employed  to  release  the 
initial  tension.  The  stutterer  can  utter  them,  apparently  for 
the  reason  that  they  mean  nothing  (See  pp.  24of.).  It  is  of 
interest  to  know  that,  whereas  all  hysterical  movements  re- 
spond to  mental  influence,  tics  do  not,  but  are  even  refractory 
to  hypnosis  (122;  206). 

The  term  "  spasm  "  is  frequently  applied  to  stutter  move- 
ments. Pitres  (15;  47),  however,  calls  attention  to  the  fact 
that  spasms  are  slow,  progressive,  and  rhythmic  contractions, 
whereas  stutter  movements  are  quick,  jerky,  arhythmic,  and 
explosive. 

b.  Larynx  Movetnents.  Another  class  of  movements,  be- 
lieved by  certain  investigators  to  be  closely  related  to  stutter- 
ing, includes  the  larynx  movements.  The  writer  holds  that 
it  is  incorrect  to  assume  that  because  the  larynx  is  a  speech 
organ  therefore  all  its  movements,  whether  normal  or  abnor- 
mal, are  essentially  related  to  the  function  of  speech.  What- 
ever superfluous  larynx  movements  are  found  to  characterize 
the  stutterer's  speech  are,  it  is  held,  to  be  regarded  as  being 
as  foreign  to  speech  as  if  they  occurred  in  a  remote  peripheral 
organ,  as  for  example,  in  the  foot,  where  thev  do  often  occur, 
and  should  be  set  down  as  accessory.  Gutzmann  has  given  an 
account  of  studies  made  of  larynx  movements  in  abnormal 
speech  (67).  The  methods  employed  were  observation  and 
palpation.  The  tip  of  the  nose  and  the  ear  lobt'B  were  held  in 
line  and  the  movements  of  the  larynx  were  observed  while  the 
subject  talked  or  sang.  Dermographic  marks  and  Roentgen 
rays  were  also  employed  in  obtaining  records.  Laryngographs 
were  devised  by  Pilton  and  improved  by  Rousselot.  Gutz- 
mann himself  used  the  Zwaardemaker  apparatus  with  the 
Krueger-Wirth  Kehltonschreiber  for  indicating  the  point  at 
which  the  vocal  sound  began. 

Gutzmann  distinguishes  the  abnormal  movements  which 
begin  at  the  larynx  from  those  which  begin  elsewhere  and 
extend  to  the  larynx.  He  believes  that  if  the  cramp  which 
closes  the  glottis  comes  when  the  larynx  is  at  its  lowest  point 
there  is  a  sudden  rise  from  top  to  bottom  of  its  position  due 
to  the  crowding  of  the  expiration  air  against  the  closed  glot- 
tis. Accompanying  this  condition  the  abdominal  muscles  are 
densely  contracted,  and  the  neck  veins  are  distended,  though 
the  neck  muscles  do  not  seem  to  be  contracted.  In  other 
cases  various  larynx  and  neck  muscles  are  involved.  Although 


224  FLETCHER 

Sikorski  (Ibid)  claims  that  the  cramped  contraction  of  the 
neck  muscles  seldom  changes  the  position  of  the  larynx  in 
any  appreciable  degree,  yet  he  considers  it  important  to  deter- 
mine which  neck  muscles  participate  in  these  cramps. 

Gutzmann  concludes  his  own  investigations  (67)  by  saying 
that  the  symptomatology  of  stuttering  is  almost  unlimited  and 
that  general  conclusions  are  therefore  impossible.  This  con- 
clusion is  in  harmony  with  the  findings  of  the  present  study 
on  breathing  (See  p.  229). 

'^  c.  Miscellaneous  Movements.  Besides  the  classified  acces- 
sory movements  already  enumerated  there  are  certain  ill- 
defined  and  miscellaneous  movements  which  usually  occur  in 
the  stutterer's  attempt  to  speak.  The  writer  has  observed 
acts  of  stamping  the  feet,  of  snapping  the  fingers,  of  twisting 
the  head,  and  of  opening  the  mouth ;  jerky  contortions  of  the 
face,  whistling,  pressing  the  tongue  against  the  roof  of  the 
mouth,  pressing  the  lips  against  the  teeth,  and  pressing  the 
lips  together. 

IV.    Psychophysical 

Under  this  heading  will  be  noted  certain  physiological 
changes  which  are  closely  associated  with,  if  not  conditioned 
by,  changes  of  mental  states  (138;  484) ;  although  not  essen- 
tially related  to  the  function  of  speech,  these  physiological 
changes  are  found  to  accompany  the  stutterer's  attempt  to 
talk.  These  are  changes  of  heart-rate,  volumetric  changes  of 
the  blood  supply,  and  galvanic  changes. 

a.  Method.  In  the  study  of  heart-rate,  and  of  distribution 
\jf  blood  supply,  the  Lehmann  plethysmograph  was  introduced, 
in  addition  to  the  pneumograph  and  microphone,  already  re- 
ported. The  subject  was  seated  as  in  the  other  investigations, 
and  with  his  right  hand  inserted  in  the  plethysmograph.  The 
stylus  of  the  plethysmograph  tambour  was  adjusted  to  a  posi- 
tion in  vertical  line  with  the  others,  in  order  to  secure  simul- 
taneously I.  the  thoracic  breathing  curve,  2.  the  abdominal 
breathing  curve,  and  the  records  j.  of  the  heart-rate,  4.  of 
the  volumetric  changes  and  5.  of  the  voice. 

The  galvanic  records  were  taken  separately  from  all  others. 
The  Deprey  d'Arsonval  galvanometer  was  employed.  The 
kind  of  electrode  that  proved  most  suited  to  our  purposes 
was  a  large  glass  jar  filled  with  a  solution  of  sodium  chloride. 
Large  copper  sheets  were  placed  around  the  inside  of  the  jar, 
and  to  these  were  soldered  the  copper  wires  which  led  through 
the  batteries  and  the  galvanometer.    In  the  bottom  of  this  jar 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  225 

was  fixed  a  wooden  handle  which  was  firmly  clasped  by  the 
subject  during  the  experiment  in  order  to  avoid  variations 
in  the  depth  of  submergence  of  the  hand.  The  jars  we'-e 
placed  on  either  side  of  a  comfortable  armchair  in  which  the 
subject  sat.  An  adjustable  reading-rack  was  placed  in  front 
of  him  so  as  to  obviate  the  necessity  of  movement.  The 
method  of  registration  was  an  adaptation  of  the  one  used 
by  Radecki  (ii6),  in  which  light  from  the  galvanometer  mir- 
ror was  thrown  on  a  graduated  scale,  which  was  set  at  a 
distance  of  one  meter  from  the  galvanometer.  A  pointer, 
suspended  from  a  cord,  ran  along  the  scale  and  could  be  made 
to  follow  the  light  as  it  changed  its  position.  The  cord  which 
carried  the  pointer  also  carried  a  wire  marker,  which  traced 
lines  horizontally  on  the  smoked  paper  of  a  kymograph.  If 
now  the  deflections  of  light  caused  by  the  turning  of  the 
galvanometer  mirror  were  accurately  followed,  the  marks  on 
the  kymograph  would  indicate  the  exact  amount  of  deflection. 

b.  Results,  a.  Volumetric  changes.  These  results  admit 
of  general  description  rather  than  tabulated  statement,  i.  It 
was  observed  that  there  was  a  marked  attention  drop  where 
the  subject  was  told  to  speak  or  read.  The  drop  was  much 
more  decided  when  the  subject  was  called  upon  to  read,  than 
when  he  was  called  upon  to  speak.  This  drop  occurred  in 
y^  per  cent,  of  the  cases.  2.  Immediately  after  the  attention 
drop  there  begins  a  rise  which  usually  lasts  until  the  end  of 
the  period  during  which  the  subject  is  stuttering.  This  is 
found  in  90  per  cent,  of  the  records.  In  some  cases  the  rise 
is  extreme,  amounting  in  one  case  to  4.3  cm.  in  43  seconds, 
and  in  another  to  5  cm.  in  31  seconds,  j.  These  rises  are 
usually  not  uniform;  they  are  characterized  by  many  fluctua- 
tions, but  they  have  a  general  upward  tendency.  In  62  per 
cent,  of  the  records  the  general  rise  is  interrupted  by  irregu- 
larities." 4.  Tests  were  made  in  which  the  subjects  were 
asked  to  imagine  themselves  in  situations  in  which  they  would 
be  likely  to  stutter,  and  to  recall,  as  vividly  as  possible,  occa- 
sions on  which  they  had  stuttered.    Some  of  the  subjects  were 

11  The  extreme  disturbances  of  breathing,  and  the  various  bodily 
movements  which  accompany  the  speech  of  the  stutterer  constitute  a 
source  of  error  in  the  use  of  the  plethysmograph  which  must  con- 
stantly and  carefully  be  guarded  against.  The  following  phenomena 
were  observed :  Sudden  bodily  movements,  especially  of  the  hand,  were 
found  to  distort  the  pulse  curve  and  were  thus  recognized ;  true 
plethysmograms  are  found  to  be  not  in  phase  with  the  corresponding 
breathing-curves ;  the  plethysmograms  that  are  affected  by  breathing 
disturbances  do  not  show  these  effects  until  from  3  to  5  seconds  after 
the  disturbance. 


226  FLETCHER 

proficient  in  this,  as  their  introspective  reports  afterwards 
showed ;  but  the  curves  showed  no  positive  changes.  In  cer- 
tain cases  there  was  a  shght  decline.  5.  The  most  important 
result  accruing  from  this  part  of  the  study  is  the  fact  that 
both  the  amount  of  the  general  rise,  and  the  distortions  of  the 
plethysmograms  are  correlated  with  the  degree  of  the  severity 
of  the  stuttering  (approximately  estimated).  This  fact  has 
been  observed  by  several  means,  a.  Records  were  made  of 
normal  individuals  while  reading;  b.  records  were  made  of 
stutterers  while  speaking  normally,  as  for  instance,  while  some 
one  was  reading  in  unison  with  them ;  c.  records  were  made  of 
cases  who  could  speak  better  while  reading  than  while  talking 
spontaneously ;  d.  finally  cases  of  severe  stuttering  were  com- 
pared with  less  severe  cases. 

/3.  Changes  in  heart-rate.  In  tabulating  the  results  of  our 
study  of  the  pulse-rate,  three  points  of  measurement  were 
chosen;  first,  a  point  in  the  period  just  prior  to  the  speaking 
interval;  secondly,  a  point  at  the  beginning  of  the  speaking 
interval ;  thirdly,  a  point  at  the  close  of  the  speaking  interval. 
The  measurements  were  made  at  ten-second  intervals ;  and 
the  numbers  thus  obtained  were  multiplied  by  six  to  give  the 
pulse-rate  per  minute. 

When  these  results  are  averaged  it  is  found  that  the  pulse- 
rate  for  the  first  period  is  90.2;  for  the  second  period,  99.8; 
and  for  the  third  period,  98.6.  The  range  of  variation  of  the 
first  period  is  from  72  to  120;  of  the  second  period  it  is  from 
78  to  126;  of  the  third  period  it  is  from  72  to  129.  One  of 
the  subjects,  W.  N.,  was  only  twelve  years  and  seven  months 
old.  Lest  there  might  be  an  error  due  to  his  naturally  higher 
heart-rate,  the  results  were  again  averaged  with  his  figures 
left  out.  These  averages  are  as  follows :  for  the  first  period, 
88.9 ;  for  the  second  period,  99.  i ;  and  for  the  third  period, 
97.2.  These  investigations  continued  through  more  than  a 
year,  so  that  the  excitement  due  to  the  novelty  of  laboratory 
conditions  cannot  be  assigned  as  an  explanation  of  the  find- 
ings.    Preliminary  tests,  moreover,  were  carefully  excluded. 

From  the  above  results  it  appears,  i.  that  the  average  pulse- 
rate  is  above  normal  in  the  period  anticipatory  of  speaking; 
2.  that  the  second  period  is  still  more  above  the  normal ;  3. 
that  the  third  period  shows  a  greater  average  than  the  first, 
but  less  than  the  second;  4.  that  in  general,  under  those  con- 
ditions that  are  calculated  to  produce  stuttering,  the  speech 
of  the  stutterer  is  attended  by  an  abnormal  acceleration  of  the 
pulse-rate. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  227 

7.  Galvanic  Changes.  The  experiments  here  reported  were 
continued  through  a  period  of  only  three  months.  While  they 
have  not  gone  far  beyond  the  preliminary  stage,  the  results 
seemed  at  least  to  merit  mention. 

During  the  progress  of  these  experiments  both  observation 
and  introspective  evidence  indicated  that  a  state  of  excite- 
ment was  present  in  the  subject  when  he  took  his  seat  in  the 
chair  in  anticipation  of  the  painful  experience  of  speaking. 
The  galvanometer  deflection  confirmed  this  indication.  It 
was  therefore  found  necessary  to  devise  a  means  of  reduc- 
ing this  state  of  tension  until  the  galvanometer  reached  a 
stable  point  which  might  be  regarded  as  a  zero  point.  We 
attempted  by  various  methods,  such  as  the  phonograph,  free 
and  pleasant  conversation,  etc.,  to  reduce  the  subject's  tension. 
During  these  preliminaries  the  experimenter  was  in  a  position 
to  observe  the  changes  in  the  galvanometer  deflection  without 
the  knowledge  of  the  subject.^^  During  this  preliminary 
period  of  relaxation  the  deflection  tended  consistently  in  one 
direction  (See  Plates;  see  also  Table  V.  p.  228).  When  the 
signal  to  read  was  given  the  deflection  began  to  take  the  oppo- 
site direction,  in  some  caess  immediately,  in  other  cases  after  a 
few  seconds.  Succeeding  most  of  the  speaking  records  there 
is  again  a  reversal  in  the  direction  of  the  deflection  and  a 
return  to  the  initial  direction  of  the  relaxation  period.  In 
the  midst  of  one  reading  period,  the  subject  became  suddenly 
amused  and  laughed  at  his  own  efforts  at  speaking.  This 
caused  a  deflection  of  15  millimeters  in  a  direction  corre- 
sponding to  that  of  the  initial  relaxation  period.  Some 
records  show  continuous  deflection  in  one  direction,  so  that 
the  greatest  deflection  appears  at  the  end  of  the  record. 
Other  records  tend  to  rise  to  the  extreme  position  at  the 
central  part  of  the  record,  and  then  gradually  subside  toward 
the  end.  Others  show  deflections  that  are  so  sudden  that  it 
was  impossible  to  follow  accurately  with  the  tracer  all  the 
changes  that  were  indicated  by  the  galvanometer  mirror.  It 
may  be  said  that  the  subject  in  whom  this  condition  was  found 
to  exist  can  read  well  under  favorable  conditions.  He  is  a 
declaimer  in  the  high  school.  Only  occasionally  does  he  halt 
at  a  word  which  he  has  seen  ahead  of  him.  It  was  at  such 
places  of  anticipated  trouble  that  the  galvanometer  changes 

18  Record  9,  Table  V  (p.  228)  shows  the  effect  of  failure  to  reduce 
this  state  of  excitement.  The  subject's  introspections  reported  excite- 
ment at  the  beginning ;  and  the  slight  variation  as  compared  with  other 
records  is  evident. 


228 


FLETCHER 


were   obtained.     The   tabulated   statement  of  the  extent  of 
these  changes  can  be  seen  by  reference  to  Table  V,  below. 

Table  V 

The  measurements  given  in  this  table  are  in  millimeters ; 
the  time  of  actual  changes  is  recorded  in  seconds.  The  meas- 
urements are  made  in  three  periods  as  follows :  Period  I  is 
the  preliminary  relaxation  period;  Period  II  is  the  interval 
during  which  the  subject  is  speaking;  while  Period  III  is 
the  final  relaxation  period  after  the  speaking  has  ceased. 
The  extent  of  the  maximum  variation  is  found  at  various 
points  in  the  speaking  period.  It  is  found  by  measuring  the 
lowest  and  the  highest  points  in  any  single,  continuous  varia- 
tion that  seems  extreme.  The  columns  under  a  indicate  the 
extent  of  the  variation  during  the  periods  indicated  above 
them ;  those  under  b  show  the  time  during  which  the  variation 
took  place. 


No.  of  Record 

Subject 

Period  I. 

Period  II. 

Period  III. 

Maximum 

a 

b 

a 

b 

a 

b 

a 

b 

1 

A.N... 
H.A... 
H.A... 
A.N... 
A.N... 
A.N... 
A.N... 
R.T... 
A.N... 
D.D... 
H.A... 

25 
33 

■3 
15 

■58 

12 
1 

1 
1.5 

i" 

1 

4.5 

i" 
1.5 

47 
28 
23 
11 
58 
23 
65 
53 
11 
21 
3 

7 

3.5 

2 

5 

3 

3.2 

4.6 

3.6 

5 

4.8 

2.5 

■36 
34 

7 

'60 
13 

'53 

i;5 
2.1 
1.2 

0.8 

'29 
'64 

'80 

is 

31 

4 

2. 

1  5 

3 

4 

1.5 

5 

6 

7 

1.5 

8 

9 

4 

10 

3.2 

11 

0.7 

The  findings  so  far  as  the  present  study  has  gone  seem  to 
show  a.  that  the  stutterer  is  subject  to  a  period  of  galvanic 
disturbance  prior  to  the  speaking  interval;  b.  that  this  condi- 
tion continues  in  varying  degree  throughout  the  interval  of 
stuttering;  c.  that,  as  with  the  volumetric  changes  (See  p. 
226),  the  degree  of  galvanic  deflections  varies  approximately 
with  the  severity  of  the  stuttering.^* 

1*  Attention  should  be  called  to  record  eleven  in  Table  V,  in  which 
the  stutterer  is  reading  in  unison  with  the  experimenter  without  stut- 
tering. The  table  shows  much  slighter  variation  in  this  record  than 
in  others  of  the  same  subject.  In  record  4  the  galvanometer  took  the 
direction    of    relaxation   while   two    stutterers    are    reading   together; 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  229 

V.     Interpretation 

It  was  thought  best  at  the  outset  to  approach  the  study 
of  stuttering  from  the  physiological  side.  This  was  done  not 
without  the  expectation  that  these  features  would  on  exami- 
nation warrant  generalizations  which  would  possess  diagnos- 
tic value.  The  findings  from  the  purely  physiological  side 
have,  however,  forced  the  conclusion  that,  taken  alone,  they 
do  not  represent  the  essential  features  of  the  phenomenon. 
The  physiological  manifestations  of  stuttering  may  be  de- 
scribed by  such  general  terms  as  "  incoordinations,"  "  dis- 
turbances," "  asynergies,"  etc. ;  but  the  description  of  the  es- 
sential, uniform  or  characteristic  features  has  not  been  pos- 
sible. The  literature  of  the  subject,  and  the  writer's  own 
studies  have  failed  to  show  precisely  what  are  those  physio- 
logical manifestations  of  stuttering  that  may  be  called  path- 
ognomonic. The  physiological  accompaniments,  as  the  fore- 
going results  have  gone  to  show,  have  not  been  uniform ;  and 
they  have  been  found  to  be  sometimes  present  and  sometimes 
absent  in  the  same  individual.  Nor  has  it  been  possible  to 
establish  the  existence  of  a  neuropathic  diathesis,  since  it  is 
impossible  to  know  how  many  neuropathic  symptoms  are  pri- 
mary or  causal,  and  how  many  are  secondary  or  sequential. 

On  the  other  hand,  however,  it  has  been  found  that  the 
|presence  of  certain  states  of  mind  is  a  constant  attendant  if 
not  an  antecedent  of  stuttering.  The  writer's  opinion  is 
that  these  are  antecedent  and  causal;  and  the  indefinite  char- 
acter and  almost  unlimited  variety  of  the  physiological  mani- 
festations of  stuttering  go  to  show  that  the  latter  are  symp- 
tomatic of  conditions  which  are  central  and  not  peripheral. 
The  possibilities  of  inhibitions,  which  may  be  regarded  as 
causing  the  initial  break  in  the  synergic  functioning  of  speech, 
are  enhanced  as  the  source  of  control  approaches  the  cortical 
regions  on  account  of  the  multiplication  of  the  synapses, 
v/hich  Sherrington  regards  as  the  seat  of  inhibition  (130; 
192).  The  remaining  portion  of  this  paper  will,  therefore, 
be  devoted  to  an  attempt  to  set  forth  as  far  as  possible  those 
states  of  mind  which  are  peculiar  to  the  stutterer  and  which 
are  associated  with  the  function  of  speech.  Since  our  sub- 
jects were  not  trained  psychologists,  it  was  naturally  impos- 
sible for  them  to  couch  their  descriptions  in  technical  termi- 
nology.   No  attempt  was  made  to  suggest  psychological  terms 

curiously  enough,  neither  one  stuttered  here,  nor  had  any  fear  of 
stuttering.  One  of  the  subjects  (A.N.)  had  just  previously  given 
a  record  in  which  the  deflection  was  64  mm.  in  the  opposite  direction. 


230  FLETCHER 

to  the  subjects ;  and  for  fear  of  doing  violence  to  the  facts 
we  prefer  to  present  the  reports  of  introspections  in  their 
original  form. 

VI.     Psychological  y 
A.  Emotions 

a.  Historical.  Hornig  (yy;  i88)  holds  that,  although  fear 
and  anxiety  aggravate  stuttering,  they  do  not  cause  it,  but 
are  merely  secondary  manifestations.  He  grants  that  emotions 
can  and  do  arise  as  effects  of  stuttering ;  and  these  same  emo- 
tions, forming  memory  complexes  which  associate  themselves 
with  the  function  of  speaking,  arise  again  when  speaking  is 
necessary  to  hinder  it  by  producing  the  inhibitions,  asyner- 
gies, etc.,  already  described.  So  that  certain  emotions  and 
stuttering  are  seen  to  operate  in  a  vicious  circle.  Wundt  holds 
(146;  65)  that  speech  originated  in  the  expression  of  emo- 
tion, and  that  movements  of  expression,  of  which  speech  is 
one,  have  continued  to  be  closely  allied  with  the  emotions. 

Gutzmann's  position  on  this  question  seems  difficult  to 
make  consistent.  He  believes  that  speech  belongs  to  the 
movements  of  expression,  and  that  it  always  exhibits  a  pleas- 
ant or  an  unpleasant  affective  tone  (48;  385  ff.).  Particularly 
does  he  think  (Ibid;  Cf.  p.  207,  above)  that  breathing  and 
voice,  no  less  than  the  mimic  muscles,  are  responsive  to  emo- 
tional conditions.  Emotions,  he  says,  always  change  the 
rhythm  and  the  depth  of  breathing,  the  costal  breathing  being 
more  responsive  than  the  abdominal.  The  fact  that  costal 
breathing  is  more  disturbed  in  stuttering  than  abdominal,  in- 
dicates that  emotions  play  a  part  here.  He  holds  that  the 
emotions  affect  the  action  of  the  vocal  cords ;  and  that  they 
play  a  prominent  part  in  the  speech  development  of  the  child. 
The  extreme  emotion  felt  by  the  deaf-mute  child  on  first 
learning  to  utter  a  word  is  cited  in  confirmation  of  this  view. 
(Ibid.,  p.  395.)  He  grants  further  that  the  cortical  and  in- 
fracortical  regions  are  more  ready  to  discharge  a  function 
when  stimulated  by  emotions ;  yet  he  holds  that  emotions 
are  of  no  fundamental  significance  in  the  causation  of  stutter- 
ing. He  believes  that  the  child  experiences  no  intensive  de- 
pression on  account  of  his  stuttering,  but  that  this  feeling  of 
depression  comes  only  with  maturer  years  and  increase  of 
intelligence.  Many  stutterers,  he  says,  have  no  experience 
that  could  be  called  "  anxiety  before  speaking,"  though  in 
reading,  such  an  experience  may  appear  in  certain  cases.  He 
claims  that  he  had  observed  "  visual  indications  "  of  emotions 
in  one  subject  just  before  coming  to  the  letter  k,  which  usu- 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  231 

ally  caused  difficulty ;  but  he  asserts  that  the  very  contrary 
conditions  are  also  found.  His  position  is  (66;  203)  that  it 
is  possible  to  eliminate  emotions  from  stuttering  without  al- 
tering the  defect/^ 

Meumann  (107;  578)  holds  that  every  child  stammers  at 
some  time  during  his  first  or  second  year.  When  stammer- 
ing has  occurred  in  the  child,  the  ridicule  and  mocking  of  his 
associates  may  produce  shyness  and  depression,  which  are 
fertile  soil  for  the  production  of  word-anxiety  and  lack  of 
confidence, — both  of  which  are  symptoms  which  characterize 
the  stutterer.  One  seems  to  be  justified  in  supposing  that 
stuttering  never  arises  in  a  permanent  form  except  through 
the  intervention  of  an  emotional  shock.  Mispronunciation, 
ataxia,  lapsus  linguae,  and  Versprechen  may  occur  under 
certain  circumstances  in  normal  individuals ;  and  these  are 
similar  to  the  first  stage  of  stuttering.  They  are  not  patho- 
logical ;  but  in  the  young  they  may  readily  become  so.  An 
American  psychologist  has  given  the  writer  a  valuable  illus- 
tration of  this  in  a  personal  experience,  which  is  quoted 
verbatim:  "  Between  the  ages  of  sixteen  and  eighteen  I  under- 
went a  dental  operation  for  straightening  the  teeth.  During 
the  time  when  I  was  wearing  a  plate  with  attachments,  my 
speech  was  seriously  interfered  with,  and  there  were  many 
sounds  that  I  was  unable  to  articulate  clearly.  On  an  occa- 
sion when  a  number  of  young  people  of  my  own  age  were 
present,  I  attempted  to  say  something  about  preliminary  col- 
lege examinations ;  the  word  "  preliminary  "  caused  me  great 
difficulty,  and  finally,  after  several  attempts,  I  was  obliged 
to  give  it  up  and  was  greatly  embarrassed  by  the  incident. 
After  the  removal  of  the  plate  I  still  found  myself  unable  to 
pronounce  the  word  (preliminary)  clearly  and  met  with  an- 
other embarrassing  experience  in  consequence.  I  have  never 
since  felt  safe  in  attempting  to  use  the  word  in  conversation, 
for  although  there  is  absolutely  no  physical  defect  and  al- 
though I  can  always  pronounce  the  word  without  difficulty 
by  pausing  a  little  and  making  an  effort,  yet  any  attempt  to 
use  it  in  conversation  is  likely  to  be  followed  by  disaster.  In 
consequence  of  this  I  invariably  avoid  using  the  word  and 
substitute  some  other  expression."  The  genesis  of  stuttering 
through  imitation  may,  in  the  writer's  opinion,  be  accounted 

15  It  seems  hardly  necessary  to  remark  that  Gutzmann's  "visual 
indications  "  are  as  inadequate  for  the  detection  of  physiological  mani- 
festations of  emotions  as  were  the  old  methods  of  observation  and 
palpation  for  the  detection  of  abnormalities  of  breathing.  The  writer 
takes  issue  with  Gutzmann's  position  and  presents  data  secured  both 
from  physiological  registrations,  and  from  introspective  reports. 


232  FLETCHER 

for  on  the  same  principle.  Prior  to  the  emotional  experience 
which  changes  its  character  and  makes  it  pathological,  the 
imitative  stuttering  develops  an  increasingly  habitual  char- 
acter. Bonnet  reports  (15 ;  55)  that  in  the  case  of  some  stut- 
terers the  mouth  is  dry  and  bitter,  and  the  tongue  feels  as 
though  it  were  covered  with  a  plaster-like  substance.  He 
finds  that  some  stutterers  have  veritable  trances  during  which 
one  may  observe  all  the  secretory  and  vaso-motor  phenomena 
that  characterize  emotions.  He  has  noticed  (15;  76)  that 
stutterers  have  less  difficulty  in  speaking  when  partially  in- 
toxicated, because,  as  they  report,  they  do  not  feel  the  same 
dread  under  these  conditions.  He  agrees  with  Merge  and 
Feindall  that  stuttering  is  more  a  matter  of  the  emotions  than 
of  the  intellect  or  the  will;  and  with  Morel  that  stuttering 
can,  like  obsession,  be  defined  as  being  at  bottom  a  morbid 
state  of  the  emotions  which  expresses  itself  by  motor  diffi- 
culties, particularly  in  articulation,  arhythmic  breathing  and 
vaso-motor  disturbances.  Stutterers  on  going  to  purchase 
a  railroad  ticket  or  an  article  in  a  store  will  often  take  along 
a  card  on  which  is  written  the  name  of  their  destination  or 
the  article  wanted.  Bonnet  (15;  71)  regards  this  as  an  un- 
mistakable sign  of  word-fear,  which  he  thinks  arises  from 
the  age  of  8  to  9,  and  is  particularly  common  between  15 
and  25. 

If  Ribot  is  correct  in  holding  (118;  171)  that,  in  certain 
individuals,  emotional  memories  are  possible,  while  in  others 
they  are  not,  it  would  seem  certain  that  stutterers  belong  to 
the  latter  class,  Titchener  claims  that  two  classes  of  indi- 
viduals are  not  to  be  differentiated  in  respect  to  this  capacity ; 
but  that  emotional  memories  are  possible  in  every  individual 
if  the  experiences  have  been  sufficiently  pronounced.  "  When 
a  boy  is  flogged  at  school,"  he  says  (138;  493  ff.),  "he  has, 
besides  the  immediate  pain  of  the  flogging,  all  sorts  of  antici- 
patory and  subsequent  stirs  of  organic  sensation, — flutterings, 
sinkings,  chokings,  breath-catchings,  nauseas.  If,  when  he 
recalls  the  flogging  in  later  life,  the  cortical  excitations  that 
underlie  his  memory-ideas  revive  the  splanchnic  and  other 
excitations  that  constitute  the  stimuli  to  organic  sensations, 
then  the  scene  comes  back  to  him  with  its  affective  coloring 
upon  it."  The  stutterer  apparently  undergoes  most,  if  not 
all,  of  the  organic  sensations  enumerated  by  Titchener.  And, 
upon  recall,  his  painful  experiences  with  attempts  at  speak- 
ing not  only  bring  back  memory-ideas  with  "  affective  color- 
ing ",  but  they  revive  in  varying  degrees  the  original  organic 
experiences. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  233 

Appelt  (i;  15)  thinks  that  stuttering  "is  purely  a  psychic 
ailment  at  whose  core  stands  the  dread  of  speaking."  This 
acts  as  "  an  inhibiting  agent "  to  obstruct  the  speech.^* 

b.  Results,  Our  data  have  been  secured  by  two  methods. 
/.  The  method  of  expression  (138;  240  ff)  employs  apparatus 
for  the  registration  of  bodily  changes  during  the  act  of  speech 
by  the  stutterer.  Detailed  reports  have  already  been  made 
of  the  studies  of  breathing,  vaso-motor,  pulse,  and  galvanic 
changes.  They  therefore  need  only  to  be  counted  in  this  con- 
nection as  objective  data  in  the  study.  2.  The  method  of  im- 
pression has,  in  the  present  research,  been  a  difficult  one  to 
employ.  The  difficulty  has  been  due  not  only  to  lack  of  psy- 
chological training  on  the  part  of  the  subjects,  but  to  the  fact 
that  even  on  immediate  retrospect  the  stutterer's  memory 
seems  vague  and  hazy  as  to  details.  He  is  often  wholly  un- 
able to  recall  what  he  has  read  only  an  instant  before.  Indis- 
tinct memories  of  his  environment  and  of  the  bodily  sensa- 
tions connected  with  his  strained  efforts  at  speaking,  espe- 
cially his  remembrance  of  sensations  in  the  throat,  the  chest, 
and  the  abdomen  constitute  his  memory  content.     In  some 

1*  The  part  played  by  the  emotions  in  stuttering  has  an  important 
analogy  in  certain  hysterical  phobias.  To  Stekel  it  is  more  than  an 
analogy,  for  he  contends  (136;  300)  that  stuttering  is  a  form  of  hys- 
teria. The  analogy  is  shown  in  certain  pathological  cases,  for  whose 
description  the  writer  is  indebted  to  Dr.  Edward  Cowles  of  Clark 
University. 

The  first  is  a  case  of  the  fear  of  sweating  reported  from  the  McLean 
Hospital,  Waverley,  Mass.  This  subject  was  frequently  distressed 
when  at  church  or  social  gatherings  by  feeling  very  warm  and  by 
excessive  perspiration.  The  hospital  report  states  that  "  the  patient 
might  be  playing  cards  when  suddenly  he  would  think  that  he  was 
going  to  get  hot;  he  would  not  sweat  for  a  time  perhaps,  but  the  idea 
that  he  was  going  to  sweat  remained  in  his  mind;  he  tried  to  get 
rid  of  the  thought  of  sweating;  he  would  become  worked  up  and 
stirred  up,  feel  a  thumping  about  the  heart,  a  disagreeable  sensation 
in  the  region  of  the  stomach,  and  the  perspiration  would  come  out." 

The  second  case  is  that  of  the  fear  of  nose-bleeding,  which  is  re- 
ported in  the  Russki  Medizinski  Vestnik,  December,  1901.  A  young 
man  became  subject  to  nose-bleeding,  which  was  generally  preceded 
by  vaso-motor  disturbances  like  blushing,  blanching,  chill  and  general 
malaise.  If  he  happened  to  leave  his  handkerchief  at  home,  or  if 
he  found  himself  in  a  place  where  it  would  be  particularly  distressing 
for  his  nose  to  bleed,  it  would  then  be  most  likely  to  occur.  If  while 
attending  a  lecture  at  the  university  the  thought  of  nose-bleeding  oc- 
curred to  him  it  would  bleed.  (One  can  ask,  in  this  connection, 
whether  the  fear  or  the  bleeding  constituted  the  obsession.  And  the 
same  question  is  also  pertinent  in  the  case  of  stuttering.  The  writer 
believes  that  the  weight  of  evidence,  in  the  present  study,  shows  that 
the  true  obsession  is  mental  in  the  case  of  stuttering.) 


234  FLETCHER 

cases  a  feeling  of  complete  bodily  relaxation  quickly  super- 
venes to  affect  the  recall.  Two  subjects  reported  that  this 
relaxation  was  so  pronounced  that  they  felt  as  if  they  would 
like  to  lie  down  and  sleep  after  a  siege  of  stuttering.  One 
subject  reported  that  while  talking  his  attention  was  divided 
between  what  he  wanted  to  say  and  what  were  his  chances  of 
saying  it  without  stuttering. 

All  of  our  subjects  reported  that  certain  letters  and  col- 
locations of  sound  looked  ominous  to  them,  if  they  ran  their 
eyes  ahead  while  reading.  Synonyms  are  constantly  employed 
as  substitutes  for  the  difficult  words. 

It  was  found  that  if  some  one  read  the  selection  aloud  with 
the  stutterer,  he  was  always  able  to  read  without  stuttering. 
An  attempt  was  made  to  obtain  data  regarding  the  states  of 
mind  under  the  two  situaticMis,  in  which  the  stutterer  is  read- 
ing alone,  and  in  which  he  is  reading  in  unison  with  some  one 
else.  (Graphic  records  have  already  been  presented,  showing 
that  there  are  differences  in  physiological  processes  in  the  two 
cases,  p.  228,  footnote,  etc.). 

Many  subjects,  were  sure  that  their  feelings  were  different 
in  the  two  cases,  but  were  unable  to  describe  the  differences. 
One  subject  reported  that  he  had  "  much  less  fear  of  failing 
when  reading  with  some  one  than  when  reading  alone." 
When  reading  with  this  subject  (A.  N.)  the  experimenter 
frequently  skipped  words,  and  even  whole  sentences;  yet  it 
was  found  that  the  stutterer  continued  to  read  through  these 
intervals  without  stuttering.  His  introspective  reports  testi- 
fied that  he  felt  "  secure  "  while  reading  alone  in  these  inter- 
vals because  he  knew  that  if  he  "  got  stuck "  he  would  be 
aided  and  prompted  by  the  experimenter. 

Other  subjects  reported  "  fear,"  "  anxiety,"  "  uneasiness," 
"  distrust  "  of  themselves,  "  lack  of  confidence,"  "  dread,"  etc. 
"A  feeling  of  strain  "  was  frequently  reported.  One  subject 
said  that  he  often  felt  himself  sweating;  and  many  felt  the 
rapid  beating  of  their  hearts. 

In  describing  his  mental  state  during  stuttering  one  subject 
(H.  A.)  said:  "When  I  am  about  to  speak,  I  am  usually 
in  a  somewhat  excited  state,  sometimes  more  so  than  at 
others ;  when  I  get  into  that  state  I  am  unable  to  control 
myself  and  I  fear  the  outcome.  I  experience  an  internal 
trembling  and  I  frequently  wonder  if  I  show  my  excitement 
to  any  great  extent.  I  wonder  sometimes  as  to  the  effects 
of  this  on  my  physical  condition.  Often  I  wish  that  I  would 
somehow  vanish  when  I  am  in  this  condition ;  and  at  other 
times  I  should  like  to  show  my  ability  in  other  lines,  such  as 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  235 

Starting  a  fight  or  throwing  some  object  through  the  window 
or  door;  it  seems  as  if  that  would  reUeve  my  state  of  ner- 
vousness." 

H.  A.  was  found  to  be  able  to  read  fluently  a  card  with 
whose  contents  he  was  familiar,  especially  if  he  had  read  the 
card  before  several  times.  On  being  asked  to  reproduce  the 
contents  of  the  card  he  would  stutter  severely.  When  asked 
to  describe  his  feelings  in  these  two  cases  he  reported  that 
in  reading  the  card  he  felt  "  confident "  that  he  could  read 
it  as  he  had  done  before ;  that  he  felt  "  passive,"  or  "  indif- 
ferent." When  asked  to  reproduce  the  contents,  he  reported 
that  his  feelings  were  changed,  that  he  now  felt  a  "  lack  of 
assurance,"  that  he  felt  himself  "  getting  excited."  He  would 
try  to  prevent  this  but  the  effort  to  do  so  made  him  worse. 
(Cf.  the  case  of  phobia,  p.  233,  footnote).  On  being  asked  to 
give  the  contents  of  the  card  he  felt  more  self-conscious  than 
in  reading  a  familiar  selection;  he  reports  that  his  attention 
is  "  very  poor  "  while  talking,  and  that  his  muscles  are  very 
tense,  especially  those  about  the  throat.  Several  subjects  re- 
ported a  "  feeling  of  dread  "  before  approaching  a  stranger 
to  whom  they  knew  they  must  speak.  One  subject  {A.  N.) 
said  that  if  he  entered  a  store  to  make  a  purchase  and  found 
no  one  there  whom  he  knew,  a  dread  seemed  to  take  hold  of 
him,  and  often  he  made  his  escape  without  purchasing. 

The  introspections  also  showed  that  after  the  speaking  in- 
terval there  continues  for  some  seconds  a  state  of  excitement 
which  gradually  subsides  to  an  indifference-point.  This  is 
corroborative  of  the  physiological  findings  already  mentioned 
(p.  228,  and  Table  V.). 

B.  Attitudes 

In  addition  to  the  more  pronounced  types  of  mental  dis- 
turbances which  have  been  studied  by  the  foregoing  methods, 
there  is  to  be  mentioned  a  group  of  mental  states  which  it 
seems  best  to  designate  as  "  attitudes."  These  states  are  not 
so  pronounced  or  intensive  as  affections  or  emotions.  They 
do  not  so  fully  emerge  into  consciousness,  and  hence  they 
do  not  so  readily  admit  of  study ;  but  they  nevertheless  exer- 
cise an  important  influence  on  stuttering,  Binet  (13)  holds 
that  in  the  attitudes,  whether  consciously  perceived  or  not, 
we  have  the  physiological  basis  of  the  emotions.  Ferrari 
(36),  in  agreement  with  this  position,  suggests  that  the  au- 
tonomic nervous  system  is  the  anatomical  substrate  of  the 
emotional  life  in  general  as  well  as  the  attitudes  mentioned 
by  Binet. 


236  FLETCHER 

The  assumption  of  the  existence  of  such  attitudes,  which 
differ  from  emotions  perhaps  only  in  degree,  seems  necessary 
to  account  for  the  extreme  physiological  effects  which  some- 
times attend  what  appear  to  be  slight  environmental  changes. 
By  means  of  this  hypothesis  it  also  seems  easier  to  account 
for  the  strength  of  the  morbid  associations  which  characterize 
stutterers.  These  attitudes  arising  from  apparently  trifling 
causes  are  again  and  again  found  to  determine  the  stutterer's 
ability  to  speak. 

It  is  interesting  to  note  that  Geissler's  study  of  conscious- 
ness under  negative  instruction  holds  that  suppression  or  in- 
hibition of  articulation  may  be  either  ideational  or  attitudinal 
(40).  Scripture  (129)  believes  that  stuttering  is  a  psycho- 
neurosis,  whose  essential  pathology  lies  in  the  disturbance  of 
the  stutterer's  feeling  toward  others.  This  disturbance  of 
the  feeling  toward  one's  environment  is  the  phenomenon 
which  is  here  to  be  discussed  as  an  attitude.  It  appears  in 
all  degrees  from  what  may  be  regarded  as  a  primarily  intel- 
lectual Einstellung  to  the  stage  at  which  it  passes  into  an 
emotion,  such  as  fear. 

In  consequence  of  our  lack  of  subjects  trained  in  introspec- 
tion, no  attempt  could  be  made  to  analyze  these  states  of 
mind;  hence  the  data  herein  submitted  are  necessarily  objec- 
tive and  sometimes  merely  inferential.  Sufficient  facts  are  at 
hand,  however,  to  make  the  point  clear.  The  number  of  these 
facts  could  have  been  extended  indefinitely.  Appelt  ( i ;  loi ) , 
who  was  himself  a  stutterer  for  many  years,  says  that  travel- 
ing in  a  strange  country  has  a  marked  salutary  effect  on  stut- 
tering; pleasant  company  has  the  same  effect.  He  finds 
further,  a  fact  often  noted,  that  in  the  presence  of  those  who 
are  in  authority  over  or  in  any  way  superior  to  the  stutterer, 
his  difficulty  is  more  pronounced.  This  is  particularly  true 
if  his  auditors  watch  him  closely. 

It  is  usually  easy  for  stutterers  to  talk  to  children  or  to 
animals.  The  thought  that  his  observer  is  unacquainted  with 
his  difficulty  is  also  helpful  to  the  stutterer  (i ;  102).  Nearly 
all  stutterers  are  able  to  speak  or  read  without  stuttering 
when  alone.  Many  stutter  in  conversation  but  do  not  stutter 
in  public  speaking.  The  most  helpless  stutterer  studied  by  the 
writer  had  during  one  summer  a  position  as  "  spieler  "  for  a 
side  show  at  a  summer  resort.  This  position  required  him 
to  stand  in  front  of  the  tent  and  announce  to  the  passers-by 
what  was  to  be  seen  within.  He  filled  this  position  with  suc- 
cess. He  stuttered  violently  in  conversation;  yet,  whenever 
he  was  called  upon  in  the  laboratory  to  give  his  side-show 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  237 

"  spiel,"  he  could  do  so  without  stuttering.  Such  expedients 
as  changing  their  style  of  speaking,  as  imitating  some  one's 
peculiar  form  of  speech,  as  getting  away  from  their  accus- 
tomed personality  and  playing  a  role  usually  make  it  possible 
for  the  severest  stutterer  to  speak  fluently  and  without  diffi- 
culty. Pitres  (15;  102)  tells  of  a  clown  who  played  his 
role  perfectly,  but  who  stuttered  so  badly  in  private  con- 
versation that  he  could  not  even  say  "  good  morning."  Many 
stuttering  actors  show  no  stuttering  when  on  the  stage.  Masks 
are  found  in  many  cases  to  relieve  stuttering.  One  of  our 
subjects  (A.  N.)  reports  that  if  he  can  get  into  the  spirit  of 
a  poem  as  he  reads  it  aloud,  and  can  feel  its  meaning  he  can 
read  it  without  stuttering. 

Bonnet  (15;  yj)  gives  an  instance  of  the  use  of  smoked 
glasses  in  certain  cases  for  the  purpose  of  giving  a  feeling 
of  isolation,  which  was  helpful  to  the  subject.  Two  of  the 
writer's  subjects  reported  that  they  had  less  difficulty  when 
speaking  in  the  presence  of  distracting  noises.  One  subject 
had  a  position  in  an  office  near  a  railroad.  He  found  that  he 
could  answer  the  telephone  when  a  train  was  passing,  but 
otherwise  he  could  not.  One  subject  reported  that  he  could 
talk  better  in  a  store  if  the  counter  over  which  he  had  to 
speak  was  a  narrow  one  than  he  could  if  it  was  a  wide  one. 
Stutterers  are  delicately  responsive  to  the  moods,  tempers 
and  attitudes  of  their  associates.  They  seem  to  "  feel  the 
presence  "  of  others  quickly  and  profoundly ;  and  their  ability 
to  taH<  is  profoundly  influenced  by  this  factor. 

C.  Imagery 

It  is  a  well-known  phenomenon  in  psychology  that  the 
kinaesthetic  images  of  a  certain  movement  of  the  body  affects 
the  power  of  voluntary  control  of  that  movement  (3)  ;  and 
this  phenomenon  is  confirmed  by  the  familiar  facts  of  stutter- 
ing, which  seems  to  take  place  more  readily  in  those  organs 
whose  functioning  is  too  complex  to  admit  of  direct  represen- 
tation in  consciousness.  The  act  of  breathing,  for  instance, 
can  be  imaged  only  partially  and  more  or  less  abstractly, 
because  the  working  of  the  diaphragm  can  not  be  imaged 
and  can  be  controlled  only  through  the  lower  arch  of  the 
abdominal  wall.  The  diaphragm  is  especially  concerned  in 
the  breathing  abnormalities  found  in  stuttering  (66).  To 
co-ordinate  vocalization  with  breathing  introduces  the  func- 
tion of  another  complication  of  muscles  which  does  not  admit 
of  direct  imaginal  representation.  The  action  of  the  articu- 
latory  organs  does  admit  of  representation  in  consciousness. 


238  FLETCHER 

and  although  stuttering  speech  manifests  itself  to  the  eye 
and  to  the  ear  as  being  primarily  a  disturbance  of  articula- 
tion, the  real  asynergy  has  been  shown  (p.  218,  above)  to  be 
not  merely  in  the  articulatory  system,  but  between  this  system 
and  others,  especially  that  of  vocalization.  Whispering,  which 
involves  only  the  musculatures  of  breathing  and  articulation, 
is  usually  found  to  be  possible  for  stutterers. 

The  organs  of  speech  are  neither  completely  under  volun- 
tary control,  nor  are  they  exclusively  non-voluntary.  The  ab- 
stract act  of  speech  may  be  called  voluntary;  but  the  co- 
ordinated action  of  the  muscles  which  execute  the  details  of 
speech  is  non-voluntary.  Speech  movements,  says  Hoepfner 
(76;  268),  are  the  first  to  lose  their  motor  (concrete?)  char- 
acter and  to  become  what  must  be  called  abstract  (begriffliche) 
movements.  The  conscious  antecedents  of  speech  movements 
seem  to  be  general,  vague,  and  except  in  the  articulatory 
movements,  lacking  in  details.  More  and  more  as  speech 
matures  is  the  attention  shifted  from  the  physiological  process 
to  the  content  of  the  thought  to  be  uttered.  It  is  suggested 
(32;  263)  that  the  cortical  centers  send  their  impulses  to 
groups  of  muscles  and  not  to  individual  muscles.  Stuttering, 
it  is  to  be  noted,  is  not  confined  to  speech.  Other  groups  of 
muscles  which  are  comparable  to  the  speech  muscles  in  the 
degree  of  complexity  and  in  the  abstract  character  of  the  con- 
scious antecedents  of  their  functioning  show  this  same  phe- 
nomenon. The  writer  has  had  one  case  of  stuttering  in 
deglutition  co-existing  with  stuttering  in  speech.  Bonnet 
(15 ;  328)  reports  a  case  of  stuttering  connected  with  defaeca- 
tion  and  deglutition.  Scripture  (128)  and  Neumann  (112) 
report  cases  of  stuttering  in  writing. 

D.  Attention 

ZoneflF  and  Meumann  (149)  have  shown  the  effect  of  atten- 
tion on  the  quality  of  the  breathing-curve.  They  find  that  in 
concentrated  attention  and  in  the  emotions,  the  thoracic  curve 
is  more  affected  than  the  abdominal.  {Cf.  the  findings  re- 
ported on  p.  215  of  this  paper.)  It  has  long  been  recognized 
that  attention  plays  a  part  in  stuttering.  It  does  not  seem, 
however,  to  exert  its  influence  only  by  direct  action  on  the 
breathing-curve,  but  rather  in  more  indirect  fashion  by  af- 
fecting the  morbid  associations  which  themselves  are  the  more 
direct  antecedents  of  stuttering. 

The  surgical  operations  practiced  by  Dieffenbach  (28)  are 
now  thought  to  have  owed  whatever  ameliorative  effect  they 
may  be  credited  with  to  their  influence  on  the  attention  of  the 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  239 

subject,  or  to  suggestion.  Placing  corks  or  wedges  between 
the  teeth,  shrugging  the  shoulders,  tapping  with  the  feet, 
pinching  with  the  fingers,  whistling  or  counting  before  speak- 
ing and  numerous  similar  therapeutic  expedients,  all  of  which 
have  been  known  to  be  effective  in  certain  cases,  seem  to  owe 
their  efficacy  to  the  fact  that  they  distract  the  attention  of 
the  stutterer  from  his  difficulty,  and  that,  in  consequence, 
they  afford  him  a  relief  from  the  morbid  inhibitions  by  which 
his  speech  is  hindered. 

Stuttering  has  frequently  been  alleviated  by  the  act  of  writ- 
ing during  speech.  Many  stutterers  can  speak  perfectly  while 
sewing,  embroidering,  or  playing  the  piano.  Others  resort 
to  blowing  the  nose,  to  scratching  the  head,  or  to  stroking 
the  mustache  before  attempting  to  speak.  One  subject 
(A.  N.)  reported  that  in  reading  aloud  alone,  which  he  could 
do  without  stuttering,  he  often  stopped  to  wonder  at  his 
success ;  and  whenever  he  did  so,  he  at  once  began  to  stutter. 
If  alone,  he  could  recover  himself ;  but  when  any  one  else  was 
present,  he  could  not.  One  person  of  normal  speech,  a  psy- 
chologist, reported  that  there  was  one  word  which  he  had 
difficulty  in  using  in  public  speaking.  If  he  used  the  word 
without  thinking  about  it,  he  had  no  trouble  in  pronouncing 
it;  but  if  his  attention  should  fall  on  it  before  he  got  to  it 
he  found  it  prudent  to  avoid  the  use  of  it.  This,  in  intensi- 
fied form,  is  the  common  experience  of  the  stutterer.  It  has 
already  been  noted  (p.  221,  above)  that  the  so-called  difficult 
consonants  are  generally  found  at  the  beginning  of  words. 
If  the  stutterer  is  able  to  begin  a  word  he  is  in  most  cases 
able  to  complete  it.  It  is  to  be  noted  that  in  all  reading,  at- 
tention is  most  keenly  concentrated  on  the  first  parts  of  the 
words.  The  introduction  of  rhythm  into  speech  has  often 
had  a  marked  effect  on  the  stutterer's  ability  to  speak. 
Rhythm,  expression,  and  distraction  from  fixed  ideas  consti- 
tute the  essential  principles  of  treatment  according  to  Scrip- 
ture (125). 

Kussmaul  (85;  23)  stated  that  stuttering  did  not  exist 
among  the  Chinese  because  of  the  rhythmic  character  of  their 
speech.  (The  1910  edition  of  his  book,  edited  by  Gutzmann, 
says  that  this  defect  should  not  exist  among  the  Chinese.) 
The  writer  has  made  sufficient  investigation  of  this  topic  to 
justify  him  in  saying  that  stuttering  does  exist  among  the 
Chinese.  Besides  numerous  private  inquiries  among  persons 
who  have  lived  in  China  and  among  those  who  have  lived 
near  Chinese  settlements  in  America,  an  attempt  was  made 
to  ascertain  if  the  Chinese  government  had  taken  notice  of- 


240  FLETCHER 

ficially  of  the  existence  of  the  defect.  The  government  had 
not  taken  official  action  on  the  question ;  but  Mr.  Jung  Kwai, 
Secretary  of  the  Imperial  Legation  at  Washington,  D.  C,  in 
answer  to  an  inquiry,  says  that  stuttering  is  by  no  means 
unknown  in  China,  and  that  more  than  one  member  of  the 
Legation  at  Washington  is  subject  to  this  defect. 

Stuttering  cannot,  therefore,  be  said  to  be  essentially  related 
to  rhythm  in  speech.  The  beneficial  results  derived  from  in- 
troducing rhythm  into  speech  seem  to  ensue  only  so  long  as 
the  innovation  is  a  novelty  to  the  stutterer,  and  therefore 
capable  of  affecting  his  attention ;  its  therapeutic  value  is  lost 
when  it  is  a  natural  characteristic  of  speech  as  is  the  case  in 
the  Chinese  language. 

It  is  to  be  noted  in  conclusion  that  the  wide  variety  of  thera- 
peutic measures  employed  for  the  treatment  of  stuttering 
could  have  ameliorative  effects  only  through  their  influence  on 
some  common  factor  such  as  attention. 

E.  Responsibility  for  Aufgahe 

Associated  with  the  emotions  and  attitudes  already  men- 
tioned, the  realization  of  his  responsibility  for  speaking  weighs 
heavily  on  the  stutterer.  When  a  question  is  put  to  him,  for 
instance,  he  feels  the  necessity  to  speak.  If  he  does  not  speak 
he  realizes  that  unpleasant  consequences  will  follow ;  the  per- 
sons with  whom  he  has  attempted  to  speak  will  become 
amused,  or  embarrassed,  if  not  angry.  If  he  were  dumb  or 
deaf  the  situation  could  be  made  intelligible  to  his  auditors, 
but  this  cannot  be  done  in  his  case.  If  he  begins  to  speak 
and  halts,  unable  to  go  further,  the  responsibility  to  proceed 
and  the  heightened  feeling  of  his  inability  to  do  so  overwhelms 
him.  The  realization  of  that  demand,  the  idea  that  something 
is  expected  of  him  by  way  of  reaction  or  reply  or  communi- 
cation in  consecutive  speech,  that  compulsion  arising  from  a 
question  put  directly  to  him,  or  a  social  or  business  situation 
in  which  he  may  find  himself,  is  the  state  of  mind  here  meant. 
If  it  were  necessary  to  choose  some  single  psychological  term 
in  present  use  to  designate  this  state,  that  term  would  be 
the  "  Aufgahe  consciousness."  With  the  stutterer  the  realiza- 
tion of  the  Aufgahe  is  keen,  if  not  morbid;  and,  as  will  ap- 
pear from  the  facts,  it  determines  his  ability  to  speak  in  many 
instances,  and  is  not  confined  merely  to  "  coloring "  his  re- 
actions. As  typical  of  this  feeling  of  the  obligation  or  neces- 
sity to  speak  Bonnet  (15;  69)  mentions  a  stutterer  who  said 
that  he  possessed  one  good  thing  which  he  could  use  only 
when  he  had  need  of  it,  namely,  speech.    One  of  the  writer's 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  241 

subjects  (A.  N.)  said  that  he  never  had  any  trouble  talking 
nonsense.  Another  subject  (H.  D.)  reported  that  when  called 
to  the  telephone  he  would  frequently  take  the  instrument  in 
his  hand  and  while  raising  it  to  his  mouth  would  keep  saying 
"  hello  "  without  removing  the  receiver  from  its  hook.  The 
instant  he  took  the  receiver  off  and  got  into  connection  with 
the  parties  at  the  other  end  of  the  line,  and  realized  a  necessity 
to  speak,  he  became  powerless  to  say  anything.  Another 
stutterer  reported  that  he  could  talk  better  to  his  mother  than 
to  any  one  else  because  she  seemed  to  have  the  ability  to  an- 
ticipate what  he  meant  to  say  and  could  relieve  him,  at  various 
points,  of  the  necessity  of  continuing  to  speak.  H.  A.  re- 
ports that  he  is  helped  if  his  auditor  seems  indifferent  to 
what  he  is  saying.  H.  D.  states :  "  I  stutter  worse  when  a 
specific  answer  is  needed,  and  when  a  person  is  looking  at 
me  to  hear  my  answer;  it  is  very  hard  for  me  to  ask  for  a 
transfer,  upon  any  particular  car-line,  such  as  Lincoln  Street, 
Greendale,  etc.  Here  a  particular  word  must  be  spoken; 
there  is  no  opportunity  to  substitute  a  word  which  I  could 
pronounce  more  easily."  Gutzmann  has  noted  that  the  stut- 
terer finds  greater  difficulty  when  a  choice  of  words  is  im- 
possible (48;  398).  A.  N.  reports  that  he  is  less  able  to 
speak  if  he  realizes  that  some  one  is  watching  him ;  the  mere 
feeling  of  the  presence  of  another  person  often  renders  him 
unable  to  speak. 

All  of  our  subjects  demonstrated  their  ability  to  read  with- 
out stuttering  when  some  one  read  in  unison  with  them.  The 
writer  feels  justified  in  concluding  that,  under  these  condi- 
tions, the  stutterer  is  not  so  clearly  conscious  of  the  Aufgahe. 
This  reHef  from  the  complete  responsibility  imposed  by  the 
Aufgahe,  together  with  the  accompanying  or  consequent 
changes  in  emotion-states,  already  described  as  characteristic 
of  these  situations  (pp.  23iff,  above),  seems  to  be  an  adequate 
indication  of  the  principle  involved. 

In  certain  tests,  already  described  (p.  225f.),  the  stutterer 
was  asked  to  recall  circumstances  under  which  he  had  stut- 
tered or  would  be  very  likely  to  stutter.  The  results  were 
wholly  negative.  The  reason  seems  to  be  that  in  this  case 
the  stutterer  was  entirely  relieved  of  the  task  of  speaking; 
and  all  efforts  to  revive  the  physiological  processes  by  mere 
recall  failed. 

The  assumption  of  the  Aufgahe  is  only  possible  when  speak- 
ing has  meaning.  Breathing,  vocalization  and  articulation, 
taken  separately  or  in  co-ordination,  are  possible  for  the 
stutterer  provided  they  do  not  have  to  cooperate  so  as  to  pro- 


242  FLETCHER 

duce  significant  speech.  That  singing  is  possible  to  the  stut- 
terer seems  to  be  due  for  the  most  part  to  the  fact  that  sing- 
ing consists  chiefly  in  vocalization  (p.  220,  above),  and  to  the 
fact  that  singers  do  not  so  much  feel  the  responsibility  of 
conveying  some  meaning  to  their  auditors. 


F.  Psychoanalysis 

An  impetus  to  the  discussion  of  psychoanalysis  in  its  rela- 
tion to  stuttering  was  given  by  Gutzmann  (55)  in  his  review 
of  two  books  on  the  subject  {Eine  neue  psychologische  Be- 
handlungsmethode  des  Stotterns  by  Netkatschew;  Nervbse 
Angstsustdnde  und  ihre  Behandlung  by  Stekel).  In  his  dis- 
cussion, Gutzmann  adheres  (55;  68)  to  his  original  somato- 
genic theory  of  stuttering.  He  claims  that  the  emotions  pres- 
ent are  secondary  and  not  primary;  and  that  stuttering  is  not 
an  anxiety  neurosis  but  an  incoordination  neurosis  due  to 
congenital  weakness  of  the  speech  apparatus.  Stekel  (p.  233, 
footnote)  holds  to  the  psychogenic  theory  of  stuttering,  and 
classifies  it  as  a  form  of  hysteria  with  an  anxiety  mechanism 
which  originates  in  sexual  traumata. 

Laubi  had  taken  the  position  (91)  that  stuttering  is  due  to  a 
mental  cause  but  is  dependent  upon  peculiar  diathesis  in  the 
form  of  congenital  or  acquired  structural  changes  in  the  nervous 
system.  The  fact  that  it  yields  to  such  a  variety  of  treatments 
warrants  him  in  calling  it  psychogenic.  In  a  subsequent  dis- 
cussion (90)  he  cites  a  case  which  he  claims  to  have  improved 
by  psychoanalysis.  Emotional  memory-complexes  he  finds  to 
be  the  cause  of  stuttering.  The  emotional  excitability  may  be 
either  inherited  or  acquired.  In  the  latter  case,  if  the  emo- 
tional experience  is  not  originally  related  to  speech  it  may 
become  so  related  by  a  process  of  transfer  (Freudian).  For 
instance,  if  stuttering  should  arise  in  a  child  as  a  result  of 
its  being  bitten  by  a  dog  named  Schnauz,  the  emotional  com- 
plex will  be  connected  with  the  memory  of  that  name;  and 
the  child  thereafter  will  probably  be  found  to  stutter  on  all 
sch  sounds.  Gutzmann  replies  (56)  that  hypnotic-psychoan- 
alytic methods  have  not  been  successful  in  the  treatment  of 
stuttering,  that  strong  mental  stimulations  may  cause  stutter- 
ing but  only  under  two  conditions, — when  the  excitement  is 
strong,  and  when  the  individual  is  susceptible.  Structural 
modifications  are  produced  in  both  cases ;  and  these  he  re- 
gards as  the  essential  causes  of  the  defect. 

Appelt  (i)  holds  to  the  Freudian  view  of  stuttering.  He 
attempts  to  show  (i ;  109)  how  erotic  impressions,  which  arise 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  243 

from  fondling  in  childhood,  come  under  the  influence  of  edu- 
cational restraints,  and  may  for  that  reason  give  rise  to  in- 
tensive inhibitions.  The  rise  of  stuttering  depends  upon  the 
extent  of  the  repression  {V erdrdngung)  and  the  peculiar  dia- 
thesis of  the  individual.  He  holds  that  shock,  fright  or  disease 
never  produce  stuttering,  but  that  these  factors  are  often  re- 
garded as  causes  by  parents  and  physicians,  whereas  the  real 
causes  lie  farther  back.  Imitation  can  only  cause  stuttering 
where  the  imitator  and  the  imitated  have  the  same  complexes. 
Freudian  identification  must  be  present  in  the  form  of  an 
unconscious  inference  that  if  the  stutterer  observed  can  have 
such  paroxysm  of  speech,  the  observer  himself  may  also  have 
them  since  he  possesses  the  same  complexes.  Appelt  classes 
stuttering  (i ;  133)  with  the  phobias  and  the  obsessions.  The 
physical  and  mental  symptoms  of  stuttering  are  "  merely  the 
projections  of  the  conflicts  which  have  accumulated  in  the 
emotional  complex.  All  paroxysms  of  stammering  (stutter- 
ing) are  produced  by  energy  which  is  supplied  by  suppressed 
libido."" 

The  writer  is  unable  to  accept  the  Freudian  interpretation   ^ 
of  stuttering  for  the  following  reasons : 

1.  He  agrees  with  Gutzmann  that  the  employment  of  the 
method  of  psychoanalysis  has  not  been  sufficiently  successful 
in  the  treatment  of  stuttering  to  warrant  its  adoption.  Treat- 
ments based  upon  other  diagnoses  have  been  much  more  suc- 
cessful. Mere  suggestion,  wholly  aside  from  the  Freudian 
hypothesis,  seems  sufficient  to  explain  the  results  of  the  use 
of  the  method. 

2.  Emotional  memory-complexes  in  children  may  be  ac- 
counted for  without  reference  to  the  sexual  element  from  the 
facts,  a,  that  speech  in  general  possesses  a  genetically  emo- 
tional character ;  h,  that  speech  in  the  child  is  usually  attended 
by  stronger  feelings  and  emotions  than  in  the  case  of 
the  adult ;  c,  that  morbid  conditions  easily  arise  with  the  child 
from  various  causes,  such  as  embarrassment  resulting  from 
errors  of  speech,  from  criticism,  from  ridicule  or  from  mock- 
ery ;  d,  that  the  child  at  an  early  age  is  compelled  to  use  the 
complex  musculatures  of  speech  without  the  possibility  of  devel- 
oping slowly  by  the  use  first  of  the  more  fundamental  and  then 
the  accessory,  according  to  the  law  for  the  best  development 
of  motor  co-ordination ;  e,  that  emotional  memory-complexes 
may  arise  from  nervous  shocks  other  than  sexual. 

1''  Scripture  {Stuttering  and  Lisping,  New  York,  1912)  seems  at  the 
present  to  accept  the  Freudian  view  of  stuttering. 


244  FLETCHER 

J.  There  seems  to  be  no  adequate  reason  for  supposing 
that  only  those  emotional  complexes  which  have  a  sexual 
origin  can  cause  stuttering.  Such  a  theory  of  stuttering, 
when  one  attempts  to  apply  it,  is  found  to  necessitate  the 
introduction  of  another  theory,  namely,  that  of  transfer,  to 
explain  how  sexual  traumata  are  switched  into  the  function 
of  speech. 

4.  The  hysterical  conditions  supposed  to  be  caused  by  the 
suppression  of  the  sexual  complexes  seem  to  be  more  charac- 
teristic of  females  than  of  males,  while  stuttering  is  many 
times  more  common  in  males  than  in  females.    (See  pp.  207f.) 


G.  Association 

In  a  former  section  (p.  221)  it  was  shown  that  the 
difficulty  encountered  by  the  stutterer  in  the  pronouncing  of 
certain  letters  is  determined,  not  by  the  nature  of  the  letters 
themselves,  but  by  the  experiences  associated  in  the  stutterer's 
mind  with  the  use  of  those  letters.  One  of  the  subjects, 
W.  N.,  acquired  a  persistent  tendency  to  stutter  in  pronounc- 
ing a  particular  word  in  consequence  of  one  unsuccessful 
attempt  to  give  a  number  while  going  through  his  regular 
lest  in  counting  from  one  to  twenty.  To  instruct  him  to  be 
on  his  guard  as  he  came  to  that  number  seemed  each  time  to 
furnish  a  positive  suggestion  to  stutter. 

Bonnet  (15;  75)  cites  a  similar  case:  A  soldier  had  an- 
swered "  present  "  for  three  months  without  stuttering.  One 
day  when  the  roll  was  called  by  a  sergeant  who  had  pun- 
ished him  the  day  before,  he  was  unable  to  answer  "  present  " ; 
and  he  continued  to  stutter  only  when  that  particular  officer 
called  the  roll.  Bonnet  holds  that  any  case  of  stuttering  which 
originates  in  reading  will  remain  a  case  of  reading-stuttering. 
The  same  phenomenon  appears  in  reciting,  in  telephoning, 
etc.  This  may  be  called  "  associative  stuttering."  It  is  not, 
however,  to  be  construed  as  meaning  a  new  variety  of  stut- 
tering. If  we  extend  the  notion  of  association  beyond  the 
range  of  conscious  ideas  and  make  it  include  a  wider  range 
of  physiological  processes,  all  stuttering  may  be  said  to  be 
associative.  As  a  descriptive  term  there  appears  no  objec- 
tion to  regarding  stuttering  as  an  "  associative  neurosis  "  pro- 
vided one  agrees  with  Donley  (33)  that  this  does  not  repre- 
sent a  "  disease  entity,"  or  a  "  disease  form,"  but  only  a 
"  functional    variation."     The    rise   of   vaso-motor,    secreto- 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  245 

motor,  and  other  physiological  changes  through  association, 
when  there  is  no  conscious  recall,  is  not  peculiar  to  stutterers 
alone.^^ 

Langf eld's  studies  (87)  show  that  in  association  experi- 
ments, where  the  reagent  is  instructed  not  to  respond  with 
the  name  of  the  presented  picture,  the  negative  Aufgabe  may 
produce  a  *'  locking  of  the  muscles  of  the  organs  of  speech," 
which  sometimes  occurs  without  "  consciousness  of  the  in- 
struction or  of  a  judgment."  He  finds  that  suppression  may 
be  present  in  various  forms,  from  a  voluntary  act  to  a  purely 
automatic  reaction.  In  the  case  of  the  stutterer,  the  Aufgabe 
consciousness  involves  no  explicit  negative  instruction  but 
the  complex  of  associations  which  is  antagonistic  to  the  posi- 
tive instructions  is  effective  in  accomplishing  the  inhibition. 

Hoepfner  (76)  holds  that  stuttering  is  an  associative  apha- 
sia. This  term  is  objectionable  only  in  that  it  generally  implies 
an  organic  lesion  or  a  structural  malformation. 

The  mechanization  of  associations  and  the  fixing  of  neural 
paths  is  unquestionably  present  in  stuttering;  and,  in  so  far, 
stuttering  falls  within  the  category  of  habit,  unless  we  choose 
to  limit  the  notion  of  habit  to  the  modifications  produced  by 
repeated  performance.^* 

Stuttering  arising  from  shock,  from  disease,  and  from  imi- 
tation (which  in  some  cases  may  be  repeated  very  few  times), 
is  obviously  not  due  to  repeated  performance.  Just  how  being 
bitten  by  a  dog  (53;  92)  can  produce  stuttering  in  the  same 
fashion  in  which  habits  are  acquired  is  not  easy  to  see ;  but 
it  is  possible  that,  in  such  a  case,  speech  may  be  regarded  as 
the  natural  mode  of  defence  through  which  the  nervous  shock 
found  expression,  and  in  doing  so  fixed  the  line  of  nervous 
discharge  as  effectively  as  repeated  performance  would.  In 
such  a  case  the  whole  anxiety  neurosis  or  association  complex 
must  become  switched  off  into  the  function  of  speech,  so  that 
it  no  longer  attaches  itself  to  the  particular  experience  of 
being  bitten  by  a  dog,  which  was  the  original  cause  of  the 

i^Betz  (11;  273  flf.)  reports  an  incident  which  seems  to  have  a 
bearing  here:  One  day,  on  a  street-car,  he  saw  a  fellow  passenger 
light  a  cigar  and  settle  back  in  his  seat  for  a  comfortable  smoke.  But 
a  sudden  jolt  of  the  car  dislodged  the  cigar  and  threw  it  upon  the 
floor;  and  the  ludicrousness  of  the  incident  caused  Betz  to  smile.  A 
few  days  later  he  saw  a  stranger  whom  he  felt  he  had  seen  before. 
In  his  prolonged  effort  to  "  place  "  the  stranger  he  found  himself  smil- 
ing ;  and  the  reproduced  smile  proved  to  be  the  medium  through  which 
the  street-car  incident  and  the  smoker's  face  were  finally  recalled. 

^^  Cf.  Baldwin  and  Stout's  discussion  of  habit  in  Baldwin's  Dic- 
tionary. 


246  FLETCHER 

shock,  but  to  the  general  function  of  speech.  It  would,  then, 
no  longer  be  a  general  condition  of  anxiety  but  would  be  con- 
nected only  with  the  act  of  speaking. 

The  part  played  by  the  element  of  conation  in  stuttering 
also  seems  to  differentiate  it  from  habit  as  commonly  under- 
stood. In  the  first  place  stuttering  in  all  of  its  pathological 
aspects  can  scarcely  constitute  the  goal  of  voluntary  effort. 
The  imitation  of  stutter  movements,  to  be  sure,  may  be  volun- 
tary and  as  such  may  obey  the  laws  of  the  acquisition  of 
habit,  but  when  this  mere  imitation  of  the  stutter  movements 
gets  to  be  actual  stuttering  a  new  condition  arises  in  which 
the  individual  becomes  a  victim  not  merely  of  the  motor  habit 
acquired  through  a  few  repetitions  but  a  victim  rather  of  the 
associated  mental  conditions.  To  illustrate,  the  writer  has 
the  history  of  a  case  in  which  a  child  became  a  stutterer  by 
attempting  to  show  his  mother  how  a  clown  had  stuttered  in 
a  circus.  If  stuttering  were  a  mere  motor  habit  it  is  evident 
that  the  clown  would  have  been  much  more  of  a  stutterer 
than  the  child  by  reason  of  the  constant  repetition  of  stutter- 
ing in  his  daily  performances. 

Again,  just  as  "  repeated  performance  "  is  not  essential  to 
the  rise  of  stuttering,  and  when  carried  out  does  not  always 
result  in  stuttering,  so  it  is  found  that  "  cures  "  are  not  al- 
ways effected  in  the  same  fashion  in  which  one  motor  habit, 
for  instance,  is  supplanted  by  another.  Many  stutterers,  for 
instance,  are  cited  (125,  126,  127)  who  ceased  to  stutter  al- 
most immediately  when  shown  how  to  introduce  some  new 
variation,  such  as  rhythm,  into  their  speech. 

It  is  to  be  noted  further  that  if  stutter  movements  were 
simply  motor  habits  like  peculiarities  of  hand-writing,  for  in- 
stance, they  would  be  expected  to  occur  with  equal  if  not 
increased  facility  in  the  absence  of  attention.  It  has  already 
been  shown  (p.  239)  that  stuttering  tends  to  disappear 
when  the  stutterer's  attention  is  distracted  from  his  speech. 

From  the  above  considerations  the  writer  has  concluded 
that  the  term  "  habit "  does  not  wholly  describe  the  true  con- 
ditions of  stuttering,  and  that  if  the  term  is  to  be  employed 
it  should  be  used  to  designate  rather  the  mental  states  which, 
it  is  held,  constitute  the  essential  pre-conditions  of  stuttering. 
But  it  is  to  be  borne  in  mind  that  these  mental  states  do  not 
obey  the  law  of  habit  by  coming  into  being  through  volitional 
conation,  nor  are  they  marked  by  a  progressive  decrease  of 
this  volitional  element  until  the  habit  has  become  fixed.     In- 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  247 

stead  they  come  involuntarily  and  there  is  no  evidence  against 
the  assumption  that  they  continue  to  be  opposed  in  equal 
degree  by  the  will  of  the  stutterer. 

VII.    Heredity 

The  study  of  heredity  in  its  relation  to  stuttering  would 
not  come  within  the  scope  of  an  experimental  attack  upon 
the  problem,  such  as  the  writer  has  undertaken.  It  will, 
therefore,  be  mentioned  only  in  so  far  as  it  has  a  bearing  on 
the  conclusions  reached  in  the  present  study.  The  facts  so 
far  known  seem  only  to  warrant  opinions  rather  than  defi- 
nite conclusions  regarding  the  inheritance  of  the  defect;  and 
the  opinions  differ.  Gutzmann  believes  that  stuttering  is  due 
to  inherited  peculiarities  of  structure  (55,  61,  122,  i&))  ;  and 
this  view  is  accepted  by  writers  less  well  known  (i5;2i). 
McReady  (97)  classifies  stuttering  with  amusia,  and  states 
that  it  is  due  to  "  biologic  variations  "  in  the  brain  centers. 
This  view  illustrates  the  futility  of  undertaking  to  base  stut- 
tering on  physical  stigmata.  A  distinguishing  characteristic 
of  stuttering  is  its  intermittence  (p.  205)  ;  if  persons  afflicted 
with  amusia  were  found  to  possess  the  power  of  tonal  dis- 
crimination when  in  certain  states  of  mind  and  not  when 
in  others  there  would  be  some  grounds  for  classifying  the 
two  defects  together. 

One  cannot  but  admit  the  possibility  and  even  probability 
that  a  favorable  neuropathic  diathesis  is  present  in  the  stut- 
terer; but  it  is  acknowledged  that  this  does  not  explain  why 
many  persons  of  neuropathic  diathesis  never  stutter.  The 
causation  of  stuttering  by  imitation  also  seems  out  of  accord 
with  the  structural  explanation  of  the  defect.  To  establish 
the  hereditary  character  of  stuttering  one  must  find  a  stutterer 
who  is  descended  from  stuttering  ancestors,  and  who  has 
never  observed  stuttering  in  others,  which  is  obviously  a  very 
difficult  thing  to  do.  One  of  the  writer's  subjects  {W.  N.) 
was  the  son  of  a  stutterer ;  and  the  father  reported  that  he 
himself  had  acquired  the  defect  by  imitating  a  school-mate. 
To  assert  that  the  son  inherited  the  father's  acquired  character 
would  be  to  cut  the  knot  of  the  whole  inheritance  problem  at 
once.  Such  errors  as  this,  it  is  feared,  have  crept  into  statis- 
tical reports  on  the  problem  of  heredity  in  stuttering. 

VIII.    Conclusions 

I.  The  motor  manifestations  of  stuttering  are  found  to 
consist  of  asynergies  in  the  functioning  of  the  three  muscula- 
tures of  speech, — ^breathing,  vocalization,  and  articulation. 


248  FLETCHER 

2.  Accompanying  these  asynergies  there  are  also  to  be 
found  tonic  and  clonic  conditions  of  other  muscles  which  are 
not  involved  in  normal  speech.  These  accessory  movements 
tend  to  become  stereotyped  in  each  individual. 

3.  Stutterers  are  found  to  differ  widely  in  type  of  asynergy, 
and  particularly  in  accessory  movements.  It  is,  therefore, 
impossible  to  assert  that  any  form  of  breathing,  of  articula- 
tion, or  of  vocalization  constitutes  the  essence  of  stuttering. 

4.  Besides  the  motor  manifestations  of  stuttering  there  are 
other  accompanying  conditions  which  consist  in  disturbances 
of  pulse-rate,  and  of  blood  distribution,  and  in  psycho-galvanic 
variations ;  these  changes  appear  before,  during,  and  after  the 
speaking  interval.  The  intensity  of  these  manifestations  is 
found  to  vary  approximately  with  the  severity  of  the  stut- 
tering. 

5.  The  essential  condition  of  the  rise  of  stuttering  seems 
to  be  a  complex  state  of  mind,  which  should  be  classified 
generically  as  feeling,  in  the  wider  sense  of  that  term  (138; 
227).  It  is  to  be  noted,  however,  that  the  quality  rather  than 
the  intensity  of  these  feeling  states  governs  the  rise  of  the 
defect.  Certain  forms  of  excitement,  such  as  that  incident 
to  speaking  in  public,  for  example,  caused  stuttering  to  dis- 
appear entirely  in  over  fifty  per  cent,  of  our  cases. 

6.  In  general  the  feelings  that  tend  toward  inhibition  or 
depression,  such  as  fear,  anxiety,  or  dread,  or  shame  or  em- 
barrassment, are  the  ones  that  are  most  likely  to  be  the  pre- 
cursors of  stuttering.  Probably  all  of  these  attendant  mental 
states  operate  in  a  vicious  circle  in  that  they  act  as  both 
cause  and  effect.  The  writer  is  of  the  opinion  that  in  general 
the  permanent  condition  of  nervousness  that  is  thought  to  be 
characteristic  of  stutterers  should  be  regarded  as  effect  rather 
than  cause. 

7.  The  states  of  feeling  that  have  to  do  with  the  produc- 
tion of  stuttering  vary  in  degree  from  strong  emotions  to  mere 
attitudes  or  moods.  These  latter  are  often  so  slight  in  degree 
that  it  is  difficult  for  the  subject  to  report  their  presence,  and 
yet  by  the  logical  "  method  of  difference  "  it  seems  necessary 
to  consider  their  presence  as  a  causal  factor. 

8.  In  addition  to  states  of  feeling,  stuttering  seems  to  be 
affected  by  the  quality  of  mental  imagery,  by  attention,  and 
by  association.  All  movements  that,  like  those  of  speech,  are 
incapable  of  clear  and  detailed  imaginal  representation  in  con- 
sciousness are,  in  the  same  way  as  speech,  liable  to  functional 

•  disorders  that  are  analogous  to  stuttering.     When  the  stut- 
terer's attention  can  be  distracted  from  his  speech  his  stut- 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  249 

taring  generally  ceases.  The  affective  and  emotional  experi- 
ences associated  with  the  pronunciation  of  sounds,  rather  than 
the  nature  of  the  sounds  themselves,  determine  the  rise  of 
stuttering. 

9.  Stuttering,  therefore,  seems  to  be  essentially  a  mental 
phenomenon  in  the  sense  that  it  is  due  to  and  dependent  upon 
certain  variations  in  mental  state.  Hence  the  study  of  stut- 
tering becomes  a  specifically  psychological  problem;  and  it 
seems  evident  that  a  detailed  analysis  of  all  the  various  as- 
pects of  the  phenomena  of  stuttering  will  furnish  important 
contributions  to  general  psychology. 

IX.    Bibliography 

-  I.    Appelt,  Alfred.    Stammering  and  Its  Permanent  Cure.    London, 
191 1,  234  pp. 

2.  AuERBACH,     S.    Traumatische    Neurose    und     Sprachstorungen. 

Monats.  f.  Psychiat.  u.  Neurol.     XVIL,   1905,  84-92. 

3.  Bair,  J.  H.    The  Practice  Curve.    A  Study  in  the  Formation  of 

Habits.     Psychol.  Rev.  Mon.  Sup.,  No.  19,  1902,  70  p. 

4.  Barber,  L     Sprachstorungen  des  Kindes.    Arts  als  Erzieher,  V., 

1909,  73-74. 

5.  Barth,  E.     Neuere  Ansichten  iiber  Stottern,  Stammeln,  Poltern, 

und    Horstummheit,    Wien.    klin.     Rundschau,   XVIII.,    1904, 
697-724. 

6.  Bayerthal,  J.    Ueber  Gehirn  und  Sprachstorungen  bei  Schulkin- 

dern.    Zeits.  f.  Kinder f or schung,  XVI.,  1910,  1-8. 
«7.    Behnke,    Emil.      On    Stammering,   Cleft   Palate,   and  Lisping. 
London,  1907,  89  pp. 

8.  Bell,  Alexander  Graham.     Lectures  upon  the  Mechanism  of 

Speech.     New  York,  1906.     129  pp. 

9.  Berger,  Hans.     Ueber  die  korperlichen  AUsserungen  psychischer 

Zustdnde.    Jena,  1907,  216  pp. 
to.     Berillon,  M.    Le  traitement  psychologique  du  begaiement  mental 
et  de  la  timidite.    Rev.  de  I'hypnot.  et  psychol.-phys.  XVIII., 
1903-4.     172-174. 

11.  Betz,    W.     Vorstellung    und    Einstellung.     Archiv   f.    d.    ges 

Psychol,  XVIL,  1910,  273-274. 

12.  Bilungs,  M.  L.  and  Shepard,  J.  F.    The  Change  of  Heart  Rate 

with  Attention.     Psychol.  Rev.  XVIL,  1910,  217-228. 

13.  Binet,  a.    Qu'est-ce  qu'une  emotion?     Annee  psychol.,  XVIL, 

191 1.    1-47. 

14.  Binet,  A.,  and  Henri,  V.    Les  actions  d'arret  dans  les  phenom- 

enes  de  la  parole.    Rev.  phil.,  XXXVIL,  1894,  608-620. 

15.  Bonnet,  Louis  A.  L.     Etude  critique  sur  la  parents  morbide  du 

begaiement  avec  les  tics  et  les  crampes  fonctionelles.     Bor- 
deaux, 1906.     168  pp. 

16.  Bramwell,  B.    Functional  Speech  Affection  Cured  by  the  Milk 

Isolation  Plan  of  Treatment.     Clin.  Studies,  IV,  1905-6,  77-79. 

17.  Brill,  A.  A.     The  Anxiety  Neuroses.     lour.  Abn.  Psychol.,  V., 

1910,  57-68. 


250  FLETCHER 

i8.  TEN  Gate,  M.  J.  Ueber  die  Untersuchung  der  Athmungsbewe- 
gung  bei  Sprachfehlern.  Monats.  f.  Sprachheilkunde,  XII., 
1902,  247-259;  321-341- 

19.  Chervin,  Arthur.     Begaiement  et  autres  maladies  fonctionelles 

de  la  parole.     Paris,  1901,  551  pp. 

20.  CoEN,  R.    Pathologic  und  Therapie  der  Sprachanomalien.    Wien, 

1886,  246  pp. 

21.  Collins,  J.    The  Faculty  of  Speech.    New  York,  1898',  432  pp. 

-  22.    CoLMAN,   U.    S.    Impediments   of   Speech.     Allbutfs  System   of 
Medicine,  VII.,  448-456. 

23.  CoLOMBAT,  Marc.     Traite  de  tons  les  vices  de  la  parole  et  en 

particulier  du  begaiement.     Paris,   1840,  558  pp. 

24.  CoNRADi,  Edward.     Psychology  and  Pathology  of  Speech  Devel- 

opment in  the  Child.    Fed.  Sem.,  XL,  1904,  327-380. 

25.  Dattner,  B.     Eine  psychoanalytische  Studie  an  einem  Stotterer. 

Centralbl.  f.  Fsychoanalyse,  II.,  191 1,  No.  i,  18-26. 

26.  Denhardt,  Rudolf.    Das  Stottern;  eine  Fsychose.    Leipzig,  1890, 

298  pp. 

27. .    Vom  Stottern.    Deutsche  Med.  Zeitung,  XXIX.,  1908, 

93  ff. 

28.  DiEFFENBACH,  J.  F.    Die  Heilung  des  Stotterns  durch  eine  neue 

chirurgische  Operation.     Berlin,  1841,  35  p. 

29.  Dittrich,  Ottmar.     Grundziige  der  Sprachpsychologie.     Halle, 

1904,  786  pp. 

30.    .     Bilderatlas  sum  ersten  Bande  der  Grundziige  der 

Sprachpsychologie.    Halle,  1903,  95  pp. 

31.  Dodge,  Raymond.     Die  motorischen  Wortvorstellungen.     Halle, 

1896,  78  pp. 

32.  Donaldson,  Henry  Herbert.    The  Growth  of  the  Brain.    Lon- 

don, 1895,  374  pp. 

33.  Donley,  John  E.    A  Further  Study  of  Association  Neuroses. 

Jour.  Abn.  Fsychol.,  II.,  1907-8,  45-57. 

34.  DuNLAp,  K.    Galvanometric  Deflection  with  Electrode  Applied  to 

the  Animal  Body.    Fsychol.  Bull.    VIL,  1910,  174-177. 

35.  DuPROT,  G.  L.    Les  troubles  de  la  parole  chez  I'enfant.     Man. 

gen.  de  I'instruction  primaire,  No.  18,  1900,  277-279. 

36.  Ferrari,  G.  C.    Le  emozioni  e  la  vita  del  subcosciente.    Rivista 

di  psicologia,  VIIL,   1912,  97-118. 

37.  FiTZ,    G.   W.    A    Study   of   Types   of   Respiratory    Movements. 

Jour.  Exper.  Med.,  I.,  1896,  677-6^12. 

38.  Foster,   Michael.     A    Text-Book    of   Fhysiology.      Sixth    Ed. 

New  York,  1893 

39.  Franz,  Shepherd  Ivory.     On  the  Functions  of  the  Cerebrum; 

the  Frontal  Lobes.    Archives  of  Psychology,  I.,  No.  2,  1907. 
64  pp. 

40.  Geissler,    L.     R.     Consciousness    under    Negative    Instruction. 

Amer.  Jour.  Fsychol,  XXIII. ,  1912,  183-213. 

41.  GiRARD,   G.    M.    De  I'anxiete.     (These   med.)      Bordeaux,    1902, 

86  pp. 

42.  Glorieux,    M.      Tic    hysterique    avec    hypertrophic    musculaire. 

Brux,  1906.     120  pp. 

43.  Godtfring,   Otto,     tjnsere  stotternden  und  stammelden  Kinder. 

Kiel,  1906.     23  pp. 

44.  Greene,  E.    The  Preponderance  of  Male  Stammerers  over  Fe- 

males.    N.  Y.  Med.  Jour.    LXXIIL,  1901.    635-638. 

45.  Gregoire,  J.    Les  vices  de  la  parole.    Paris,  1908.     119  pp. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  251 

46.  Grossard,   M.     Begaiement  et  vegetations  adenoides.     Bull,  de 

lar.,  otol.  et  rhin.,  VI.,  1903.    261-266. 

47.  Grunbaum,  Ferdinand.    Erkldrung  des  Stotterns,  dessen  Heilung 

und  Verhiltung.    Leipzig,  1897.    63  pp. 

48.  GuTZMANN,    Hermann.    Das    Verhaltnis    der    Affekte    zu    den 

Sprachstorungen.    Zeits.  f.  klin.  Med.     LVIL,  1905.     385-400. 

49. .    Ueber    Sprachstorungen   bei   Neurasthenikern.     Ver- 

handl.  d.  Kong.  f.  inner e  Med.    XXL,  1901.    518-522. 
50. .    Ueber    Untersuchung    und    Behandlung    der    durch 

Gaumen-    oder    Zahndefekte    entstehenden     Sprachstorungen 
Deutsche  Zahnartzl.     Wochenschr.     VIII.,   1905.     186-209. 
51. .    Die  Sprachstorungen  als  Gegenstand   des  klinischen 

Unterrichts.    Leipzig,  1905.    39  pp. 
52.    .     Stimmbildung   und  StimmpAege.     Wiesbaden,    1906 

161  pp. 
53. .    Sprachstorungen  und  Sprachheilkunde.     Berlin,  1908. 

189  pp. 
54. .    Grundziige  der  Behandlung  der  nervosen  Sprachstor- 
ungen.   Deutsche  Med.  Wochenschr.,  XXXIL,  1906.    612-617. 
55.    .     Ueber   psychogenen    Sprachstorungen.     Monats.   f. 

Sprachheilkunde,  XX.,  1910.    93-94;  97-ii7- 
56. .    Nochmals  die  psychogenen  Sprachstorungen.    Monats. 

f.  Sprachheilkunde,  XX.,  1910.    204-210;  241-247. 

57. .    Das  Stottern.     Frankfurt  a.  M.,  1898.    460  pp. 

58. .     Die  soziale  Bedeutung  der  Sprachstorungen.     Klin. 

Jahrh.     XII.,  1904.    295-364. 
59. .    Ueber  die  neueren  Fortschritte  in  der  Untersuchung 

und  Behandlung  der  Sprachstorungen.    Zeits.  f.  diact.  u.  phys. 

Therapie.     VIIL,   1904-5.     531-604. 
60. .     Sur  le  symptomatologie  et  le  traitement  de  I'aphonie 

spasmodique  et  d'autres  troubles  phonateurs  d'origine.    Archiv 

internat.  de  laryng.    XXL,  1906.    689-723. 
61. .    Ueber  die  Bedeutung  der  Erblichkeit  ftir  die  Entste- 

hung  von   Sprachstorungen.     Zeits.   f.   aertzl.   Fortbild.     IV, 

1907.    481-489. 
62. .    Des  Kindes  Sprache  und  Sprachfehler.    Leipzig,  1894, 

264  pp. 
63. .    Die  Heilkurse  fiir  Stotterenden.     Monats.  f.  Sprach- 
heilkunde.   XVIL,  1907.    386-391. 
64. .    Physiologic  der  Stimme  und  Sprache.    Braunschweig, 

1909.    208  pp. 
65. .    Stimmbildung   und   StimmpAege.     Wiesbaden,    1906, 

161  pp. 
66. .    Die    Atembewegung     in    ihrer    Beziehung     zu    den 

Sprachstorungen.     Monats.  f.  Sprachheilkunde.    XVIIL,  1908. 

179-201. 
67. .     Ueber  Stellung  und  Beviregung  des  Kehlkopfes  bei 

normalen  und  pathologischen  Sprachvorgangen.    Beitr.  z.  Anat. 

Physiol.  Path.  u.  Ther.  des  Ohres,  usw.     I.,  1908.     89-133. 
68 .    Ueber  die  spastischen  Stimmstorungen  und  ihre  Be- 
handlung.   Med.  Bl..     XXVIII.  1905-    543  ff. 
69. .     Sprachstorungen  und  Rhino-Laryngologie.    Zeits.  f. 

Laryngologie,  I.,  1908.    97-99- 
70. .       Ueber  die  Bedeutung  des  Vibrationsgefiihls  fiir  die 

Stimmbildung  Taubstummer   und    Schwerhoriger.     Monats.   f. 

Sprachheilkunde,  XVIL,  1907.     59  ff. 


252  FLETCHER 

71. .     Zur    Frage    der    gegenseitigen    Beziehung    zwischen 

Bauch-  und   Brustatmung.     (Verhandl.  d.  XX.  Congresses  f. 

innere  Med.)    Monats.  f.  Sprachheilkunde,  XVIII.,  1908.  223  ff. 
7^.     Hall,  G.   Stanley.     Educational  Problems.     New   York,   191 1, 

II.    714  pp. 
y:i. .    A    Study    of    Fears.     Amer.   Jour.   Psychol.,   VIII., 

1897.     147-249. 

74.  Halle,    .    Ueber    Storungen    der    Atmung    bei    Stotterern. 

Monats.  f.  Sprachheilkunde,  X.,  1900.    225-236. 

75.  HoEPFNER,  T.     Psychologisches    iiber     Stottern    und    Sprechen. 

Zeits.  f.  Psychotherapie  u.  med,  Psychol.    III.,  191 1.   264-289. 

76. .     Stottern   als   assoziative   Aphasie.     Zeits.  f.   Patho- 

psychol.,  I.,   1912.     449-552. 
77.    HoRNiG,  Reinhold.   Untersuchungen  iiber  das  Wesen  und  Heilung 
des  Stotterns.     Monats.  f.  Sprachheilkunde,  XIX.,  1909.     157- 
160;  183-192. 

*  78.    Hunt,    James.      Stammering    and    Stuttering.      London,    1865. 
258  pp. 

-  79.    Ibershoff  a.  E.    On  the  Nature,  Causes,  and  Treatment  of  Stut- 
tering, etc.     Med.  Brief.     XXXVI.,  1908.     202-208. 

80.  Ives,  M.  J.    Illustrated  Phonetics.     New  York,  1909.     132  pp. 

81.  Janet,    Pierre     M.     F.     The    Major    Symptoms    of    Hysteria. 

(Trans.)     New  York  1907.    345  pp. 

82.  Jones,     Ernest.      Zwei    interessante     Falle    von    Versprechen. 

Zentralbl.  f.  Psychoanalyse,  II.,  191 1.    33-34. 

83.  KiESOW,  F.    Versuche  mit  Mosso's  Sphygmomanometer  iiber  die 

durch   psychische   Erregungen   usw.     Phil.   Stud.     XL,   1895. 
41-60. 

84.  KoEHLER,  W.     Akustische  Untersuchungen  I.     Zeits.  f.  Psychol., 

LI  v.,  1910.      241-289. 

85.  Krause,  F.    Horen  und  Sprechen.     Coethen,  1905.     198  pp. 

86.  Kussmaul,  Adolf.    Die  Storungen  der  Sprache.     Vierte  Aufl., 

von  H.  Gutzmann.    Leipzig,  1910.    409  pp. 

87.  Langfeld,  Herbert  Sidney.     Suppression  with  Negative  Instruc- 

tion.   Psychol.  Bull.,  VII.  1910.    200-208. 

88.  Langwill  H.  G.     Stammering  and  Its  Treatment.     The  Practi- 

tioner, LXXXV.,  1910.    568-582. 
89. .    A  Plea  for  the  Scientific  Treatment  of  Stammering. 

Rev.  Neur.  and  Psychiatry,  V.,  1907.    259-280. 
90.    Laubi,   Otto.     Ein   Fall  von   Psychoanalyse  bei  einem  erwach- 

senen    Stotterer.      Monats.    f.    Sprachheilkunde,    XXL,    191 1. 

62-72;  111-118. 
91. .     Psychische  Einfliisse  bei  der  Aetiologie  und  Behand- 

lung  des  Stotterns.    Monats.  f.  Sprachheilkunde,  XVII. ,  1907. 

411-418. 
92.    Legel,   O.    Die   Sprache   und  ihre  Storungen,  usw.     Potsdam, 

1905.    322  pp. 
93. .    Des   Kindes   Sprachstorungen    {Stottern,   Stammeln, 

Lispeln,  usw.)  und  ihre  Heilung.    Potsdam,  1908.    222  pp. 

94.  Leroy,  E.  B.    Le  langage:   essai  sur  la  psychologie  normale  et 

pathologique  de  cette  fonction.     Paris,  1905.     293  pp. 

95.  Liebmann,  a.     Vorlesungen  iiber  Sprachstorungen.    Berlin,  1906. 

132  pp. 

96.  Maas,    Paul.     Die    Sprache    des   Kindes   und   ihre    Storungen. 

Kinderfehler,  XV.,  1909-10.     32  ff. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  253 

97.  MacCready,   E.    B.     The    Relation   of    Stuttering    to    Amusia. 

Jour.  Amcr.  Med.  Ass'n.,  LV.,  1910.    208  ff. 

98.  Makuen,    G.    Hudson.     Nomenclature    of    Defects    of    Speech. 

Laryngoscope,  XX.,  1910.     1070-1073. 
99. .     What  the  Laryngologist  may  do  for  the  Correction 

of  some  of  the  more  common  Forms  of  Speech  Defects.     Tr. 

Amer.  Laryng.,  RhinoL,  and  Otol.  Soc,   1904-5.     81-88. 
100. .    What  Shall  We  Do  with  the  Stammerer?     Intemat. 

Med.  Mag.,  XII.,  1903.     728-730. 
101. .    An  Unusual  Form  of  Stammering.    St  Bartholomew 

Hasp.  Report,  XLL,  1906.    534  ff. 
102. .     The  Physiology  of  Language  and  its  Relation  to  the 

Treatment  of  Stammering.    N.  Y.  Med.  Jour.,  LXXXIV.,  1906. 

1261-1263. 
103. .    A  Brief  History  of  the  Treatment  of  Stammering. 

Phil.  Med.  Jour.,  XIII,  1909-10.     191-197. 

104.  Marbe,  K.  and  Seddig,  M.    Untersuchungen  schwingender  Flam- 

men.     Annalen  d.  Physik   (IV.  Folge),  XXX.,  1909.     579-592. 

105.  MentZj  Paul.     Die  Wirkung  akustischer  Sinnersreize  auf  Puis 

und  Athmung.     Phil.  Stud.,  XL,  1895.     61-124;  371-393;  563- 
602. 

106.  Meumann,  E.    Die  Sprache  des  Kindes.    Ziirich,  1903.    82  pp. 
107. .     Vorlesungen   sur  Einfiihrung   in   die  experimentelle 

Pddagogik,  II.  Aufl.     Leipzig,  191 1,  I.,  726  pp. 

108.  Mieleche,    a.    Ueber    Stottern    als    padagogische    Fehler    usw. 

Monats.  f.  Sprachheilkunde,  XVIL,  1907.     364-370. 

109.  MoTT,  F.  W.     The  Brain  and  the   Voice  in  Speech  and  Song. 

New  York,  1910.    112  pp. 
no.     Nagel,  W.     Handbuch  der  Physiologic  des  Menschen.     Braun- 
schweig, 1909,  IV.     992  pp. 

111.  Neuhoff,  J.    Das  Stottern  und  andere  Sprachfehler.     Leipzig, 

1908.    35  pp. 

112.  Neumann,  A.     Ueber  Sprachstorungen  und  Stottern  betm  Schrei- 

ben.     Graz,  1893.    94  pp.       _ 

113.  Oltuszewski,    W.    Psychologic   und    Philosophic    der   Sprache. 

Berlin,  1901.    70  pp. 

114.  Peterson,    F.    and   Jung,    C.    G.     Psychophysical    Investigations 

with  the  Galvanometer  and  Pneumograph  in  Normal  and  In- 
sane Individuals.    Brain,  XXX.  1907.     153-218. 

115.  Pillon,   F.    La  memoire   affective:   son   importance   theoretique 

et  pratique.    Rev.  phil,  LI.,  1901.     1 13-138. 

116.  Radecki,    W.     Recherches    experimentelles    sur    les    phenomenes 

psycho-electriques.    Arch,  de  psychol.,  XL,  191 1.    209-293. 

117.  Reichhardt,    M.    Die   seelischen    Hemmungserscheinungen    des 

Stotterns:    Eine   pddagogisch-psychologische  Studie.     Leipzig, 
1903.    27  pp. 

118.  RiBOT,  Th.     The  Psychology  of  the  Emotions.     (Trans.)     New 

York,  1897.     455  PP- 

119.  RiCKSHER,  C,  and  Jung,  C.  G.    Galvanic  Phenomena  and  Respira- 

tion.   Jour.  Abn.  Psychol.,  XL,  1907-8.     189-317. 

120.  RouMA,  G.     Enquete  scolaire  sur  les  troubles  de  la  parole  chez 

les  ecoliers  beiges.    Intemat.  Archiv  f.  Schulhygiene,  II.,  1906. 
151-189. 

121.  RoussELOT,     P.     J.    Phonetique     experimentale.       Paris,     1908. 

1252  pp. 


254  FLETCHER 

122.  Sarbo,  Arthur  von.  Maladie  des  Tics  und  die  damit  in  Ver- 
bindung  stehenden  Sprachstorungen.  Monats.  f.  Sprachheil- 
kunde,  XVII,  1907.     178-183;  205-210. 

123. .    Die  hysterischen  Sprachstorungen.   Monats.  f.  Sprach- 

heilkunde,  XVII.,  1907.    97-106;  140-149. 

124.  ScHAEFER,  E.  A.     Text-Book  of  Physiology.     N.   Y.,   1898,   II, 

1365  PP 

125.  Scripture,  E.  W.    The  Treatment  of  Negligent  Speech  by  the 

General  Practitioner.    Med.  Rec,  LXXIV.,  1908.    257-260. 
126. .    The   Treatment   of   Stuttering.     Med.   Rec,   LXXI., 

1907.    771  ff. 
127. .    The    Treatment    of    Hyperphonia     (Stuttering    and 

Stammering)     by     the     General     Practitioner.      Med.     Rec, 

LXXIIL,  1908.    480-481. 
128. .     Penmanship    Stuttering.     Jour.   Amer.   Med.   Ass'n., 

LIL,  1909.    1480-1481. 
129. .    Stammering :  Its  Nature  and  Treatment.   Synopsis  of 

Lecture  before  Boston  Soc.  of  Neurol,  and  Psychiatry.  Bos- 
ton, May  10,  1912. 

130.  Sherrington,  C.  S.    The  Integrative  Action  of  the  Nervous  Sys- 

tem.    New  York,  1906.    411  pp. 

131.  SiDis,  B.    The  Galvanic  Phenomena.  Psychol.  Bull.     VII.,  1910. 

321-322. 
132. .    The  Nature  and  Causation  of  the  Galvanic  Pheno- 
mena.   Psychol.  Rev.,  XVII.,  1910.    19-36. 

133.  SiDis,  B.,  and  Kalmus,  H.  T.    The  Study  of  Galvanometric  De- 

flections.   Psychol.  Rev.,  XV.,  1908.    391-396. 

134.  Smith,    Theodate    L.    On    Muscular    Memory.      Amer.    Jour. 

Psychol,  VII.,  1895-6.    453-490. 

135.  Starch,  D.     Mental   Processes  and  Concomitant  Galvanometric 

Changes.    Psychol.  Rev.,  XVII.,  1910.    19-36. 

136.  Stekel,  William.    Nervose  Angszustdnde  und  ihre  Behandlung. 

II.  Aufl.    Berlin,  1912.    448  pp. 

137.  Thumb,    A.    Die    experimentelle    Psychologie    in    Dienste    der 

Sprachwissenschaft.     Marburg,  1909.     13  pp. 

138.  Titchener,   E.   B.    a    Text-Book   of  Psychology.     New   York, 

191 1.    565  pp. 

139.  Tomor,  Ernest.    Die  Rolle  der  Muskeln  beim  Denken.    Archiv. 

f.  d.  ges  Psychol.,  XVII.,  1910.    362-366. 

140.  VAN  DER  ToRREN,  J.    Das  normale  Verhoren,  Versprechen,  Ver- 

lesen,  und  Verschreiben,  nebst  ihren  Beziehungen  zur  Path- 
ologic. Zeits.  f.  d.  ges.  Neurol,  u.  Psychiatric,  IV.,  1911-1912. 
657-678. 

141.  Town,  Clara  Harrison.    Congenital  Aphasia.     Psychol.   Clin., 

v.,  191 1.     167-179. 

142.  Troemner,    E.    Zur    Pathogenese    und    Therapie    des    Stotterns. 

Wien.  klin.  ther.  IVoch.  XII.,  1905.  189-196;  219-223. 

143. .    Ursachen    und    Handlung  des    Stotterns.     Deutsche 

Med.  Woch.,  XXX.,  1904.    1336  ff. 

144.  Varendonck,  J.     Phobies  d'enfants.  Rev.  Psychol,  III.,   1910. 

5-45- 

145.  Wells,  F.  L.,  and  Forbes,  A.    On  Certain  Electrical  Processes  in 

the  Human  Body  and  Their  Relation  to  Emotional  Reactions. 
Archives  of  Psychol,  II.,  No.  16,  1911.     1-39. 

146.  Wundt,    William.     Volkerpsychologie:    Die    Sprache.      Berlin, 

1911.    695  pp. 


AN  EXPERIMENTAL  STUDY  OF  STUTTERING  255 

147.  Wyllie,   John.    The    Disorders   of   Speech.     Edinburgh,   1894. 

495  pp. 

148.  Zahn,    Th.    Ueber    die    Ursachen    des    Stotterns.      Monats.    f. 

Sprachheilkunde.  XXL,  191 1.     149-158. 

149.  ZoNEFF,    P.,    and    Meumann,    E.      Ueber    Begleiterscheinungen 

psychischer    Vorgange    in    Athem     und     Puis.      Phil.    Stud., 
XVIIL,  1902.     1-113. 

150.  ZuND-BuRGUET,    A.      fitude    physiologique    et    pratique    sur   les 

troubles  externes  ou  mechaniques  de  la  parole.    Arch.  Internat. 
de  Laryng.,  XIX.     1905.    486;  825;  XX.,  1906,  856  flf.;  XXL, 
1907.    186  ff. 
(Since  the  completion  of  this  study  two  books  have  appeared  that 
should  be  added  to  the  above  list.) 

151.  Bluemel,  C.   S.    Stammering  and   Cognate  Defects  of  Speech. 

New  York,  1913.    2  v. 

152.  Scripture,   E.   W.    Stuttering  and  Lisping.     New   York,   1912. 

251  pp. 


X.     Illustrative  Plates 

Typical  records  are  here  reproduced  to  illustrate  certain 
physiological  phenomena  that  accompany  stuttering,  not  all 
of  which  are  amenable  to  detailed  description  or  tabulation. 
The  records  read  from  left  to  right;  the  time  is  recorded  in 
seconds.  In  all  the  breathing  records  the  amount  of  inhala- 
tion is  registered  by  the  downward  movement  of  the  stylus, 
that  of  exhalation  is  indicated  by  the  upward  movement ;  the 
duration  of  both  inhalation  and  exhalation  is  measured  by 
the  extent  of  the  movement  in  the  horizontal  direction.  By 
comparing  all  points  of  each  curve  that  lie  on  a  line  drawn 
perpendicular  to  the  line  of  movement  of  the  drum  the  tem- 
poral relations  of  the  different  phases  of  the  processes  re- 
corded can  be  determined. 


Plate  A  gives  two  records  taken  at  different  intervals  and  showring 
the  thoracic  curve  above  and  the  abdominal  curve  below  in  each  case. 
Below  the  abdominal  curve  of  each  record,  the  registration  of  the 
microphone  is  shown  by  the  vip  and  down  movements  of  the  stylus. 
The  abnormality  of  this  record  is  shown  in  the  arhythmic  character 
of  the  breathing  curve  and  also  in  the  scantiness  of  the  voice  record. 

Pl.\te  B  is  reproduced  for  the  purpose  of  comparing  it  with  record 
C  following  to  illustrate  the  possibility  of  both  normal  and  abnormal 
speaking  in  the  same  subject.  The  perpendicular  lines  are  drawn  to 
show  the  method  of  comparing  the  several  registrations.  In  this 
record  the  subject  is  stuttering,  while  in  record  C  he  is  speaking 
normally.  Note  the  tendency  to  attempt  to  speak  when  the  lungs 
are  empty,  and  even  during  the  exhalation  period. 

Plate  C  is  to  be  compared  with  record  B.  The  regular  succession 
of  inhalation  by  exhalation,  the  short  inhalation  and  the  long  ex- 
halation period,  also  the  complete  utilization  of  the  exhalation  period 
by  vocalization,  as  shown  by  the  microphone  record,  are  the  chief 
-points  of  difference  between  the  two. 

Plate  D  gives  a  plethysmogram  showing  simultaneously  the  volu- 
metric changes  and  the  heart-rate,  also  the  thoracic  and  the  abdominal 
■breathing  curves.  Sudden  breathing  and  vaso-motor  changes  are  seen 
to  mark  the  period  of  the  beginning  of  speech. 

Plate  E  gives  the  same  as  record  D  with  the  addition  of  a  voice 
record.  In  addition  to  the  marked  irregularities  of  the  breathing 
curve  the  steady  rise  of  the  plethysmographic  curve  is  to  be  noted. 
The  full  extent  of  this  rise  is  greater  than  could  be  shown  in  the 
length  of  the  reproduction  here  given. 

Plate  F  shows  the  tracings  that  followed  the  deflections  of  the 
galvanometer  during  the  stuttering  of  two  subjects  H.  A.  (top),  and 
A.  N.  (bottom).  A.  N.  is  a  much  worse  stutterer  than  H.  A.,  and 
there  is  also  found  in  his  case  a  much  wider  deflection.  It  is  seen 
that  A.  N.'s  curve  reaches  a  maximum  and  then  moves  gradually  in 
the  direction  of  relaxation,  or  upward. 

Plate  G  shows  the  galvanometer  deflections  obtained  from  the  same 
subject  when  reading  under  different  conditions.  In  the  first  regis- 
tration, A.  B.,  the  subject,  is  reading  alone  and  stuttering.  In  the 
second  registration  he  is  reading  with  the  experimenter,  a  to  /?,  with- 
out stuttering,  and  also  relaxing,  /3  to  ;'.  The  introspective  report  of 
this  record  showed  the  presence  of  "  strain,"  and  "  lack  of  confidence  " 
in  the  first  registration,  and  "  less  emotional  excitement "  in  the  second. 


14  DAY  USE 

RETURN  TO  DESK  FROM  WHICH  BORROWED 

neiQcv  umm 

This  book  is  due  on  the  last  date  stamped  below,  or 

on  the  date  to  which  renewed. 

Renewed  books  are  subject  to  immediate  recall. 

MAR  14  1966 

7Mr'66SH 

AUG  25  1970 

AUG  2  6  1970  0  7 

j 

LD21-40rr,.5.'6-                             ,,   . Genial  Library 
(Fi3n-   ■       ■  ~  r                              University  of  Cahrornia 

Berkeley 

